The effect of intra-operative passive movement therapy on non-surgical site pain after breast reconstructive surgery: a preliminary study

Pain distant to an operative site is under-reported but sometimes more severe than pain from the surgical site. Intra-operative passive movement could possibly reduce this pain. This preliminary study was designed to assess the practicalities of conducting a randomised controlled trial of this therapy in anaesthetised patients. The study design was pragmatic. Forty-two patients undergoing breast reconstruction were randomly assigned to receive either intra-operative passive movement or standard care. Twenty-four hours after surgery, median (IQR [range]) morphine consumption was 33 (11-42 [0-176]) mg in the passive movement group compared with 74 (15-118 [0-238]) mg with standard care (p = 0.126), while participants reported median (IQR [range]) visual analogue scores in areas distant from the surgical site of 0 (0-4 [0-34]) mm in the passive movement group compared with 10 (2-30 [0-57]) mm in those receiving standard care (p = 0.002). A full trial of intra-operative passive movement therapy to reduce postoperative is feasible and warranted.