The Role of Muscle Relaxants – Spasmolytic (Thiocochlicoside) in Postoperative Pain Management after Mastectomy and Breast Reconstruction

Purpose: Post-operative pain after breast cancer surgery is a major problem and women undergoing mastectomyand breast reconstruction experience post-operative pain syndromes in approximately one-half of all cases. Patientswho have undergone breast reconstruction after mastectomy can suffer from acute postoperative pain with moderateor strong tension. In some cases, chronic neuropathic pain syndromes may occur after surgery. Opioids are used totreat pain, with serious side effects. The systemic postoperative analgesic regimen as thiocochlicoside P.O. alongwith paracetamol and NSAIDs I.V., which may limit the administration of opioids without reducing pain relief,seems to be necessary. Materials and Methods: This study was a clinical trial randomizing 70 patients undergoingbreast reconstruction. Two main protocols of systematic post-operative analgesia, one using thiocochlicoside (groupA) and the other without them (group B), were used. Both groups received paracetamol X3 and lornoxicam X2 I.V.systematically. The pain measurement scale (NPS) used to measure post-operative pain. Likert scales were used toevaluate patient’s satisfaction and the difficulty from the side effects . An anonymous questionnaire was used for thedata collection. Results: Statistically significant difference was found between pain on the day of surgery (p = 0.017)as well as the three subsequent days (p = 0.000). In group A , pain was reduced directly to half (Χ2 surgery pain =93.888, p = 0.000) especially on the first post-operative day. In group A the satisfaction with analgesic treatment washigher than in group B (p = 0.002). Conclusion: The use of thiocochlicoside in post-operative analgesia in breastreconstruction after mastectomy contributes to reduce the pain intensity experienced by patients and to reduce the sideeffects of opioid analgesics as a result of reduced demand for opioid analgesics. Patients who received the analgesiausing muscle relaxants-spasmolytic reported greater satisfaction.