{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T09:12:55Z","timestamp":1789809175601,"version":"4.0.1"},"reference-count":22,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tapentadol, a centrally acting \u03bc-opioid receptor agonist and noradrenaline reuptake inhibitor, has shown promise in providing potent analgesia with fewer opioid-related side effects. This study evaluated its role as a pre-emptive analgesic in cancer patients undergoing breast conservation surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A prospective, double-blinded, randomized controlled trial was conducted on 70 American Society of Anesthesiologists class II adult females, scheduled for conservative breast surgery, randomized into two groups after informed consent. Group A received 75 mg oral tapentadol, and Group B an oral placebo, one hour before induction. Intraoperatively, more than 20% increase in mean arterial pressure from baseline, and postoperatively, pain score (at 1, 2, 3, and 4 hours) greater than 3 was treated with intravenous morphine (up to 0.1 mg\/kg). Data regarding total morphine used (dose and number of patients) intra-operatively and postoperatively, time to first rescue dose, and pain scores postoperatively, and side effects were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean intraoperative morphine requirement was significantly lower in the tapentadol group (1.11 \u00b1 1.53 mg) compared with the placebo group (3.36 \u00b1 1.60 mg;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Only 13 (37.1%) patients in the tapentadol group required intraoperative morphine compared to 31 (88.6%) in the placebo group (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Postoperative pain scores were lower in the tapentadol group at 1 hour (1.89 \u00b1 0.83 vs 2.46 \u00b1 1.15, p = 0.020) and 3 hours (1.06 \u00b1 0.24 vs 1.23 \u00b1 0.43,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.042). Rescue morphine use post op was lower in the tapentadol group [5 (14.3%) vs.10 (28.6%),\n                      <jats:italic>p<\/jats:italic>\n                      = 0.145] with a longer time to first rescue dose (58.0 \u00b1 21.7 vs. 43.5 \u00b1 27.3 minutes,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.290).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pre-emptive tapentadol administration significantly reduced perioperative morphine use and improved postoperative pain scores at certain time points. However, the increase in time to first rescue analgesia was not statistically significant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/jcas-2026-0012","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T08:31:23Z","timestamp":1789806683000},"page":"78-84","source":"Crossref","is-referenced-by-count":0,"title":["Role of Preoperative Tapentadol in Reduction of Peri-operative Analgesics Requirements After Breast Conservative Surgery in Cancer Patients: A Randomized Controlled Trial"],"prefix":"10.2478","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6837-1858","authenticated-orcid":false,"given":"Yusra","family":"Saleem","sequence":"first","affiliation":[{"name":"Resident Anesthesia, Shaukat Khanum Memorial Cancer Hospital and Research Center , Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allah Ditta","family":"Ashfaq","sequence":"additional","affiliation":[{"name":"Consultant Anesthesia, Shaukat Khanum Memorial Cancer Hospital and Research Center , Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Raza","family":"Mehdi","sequence":"additional","affiliation":[{"name":"Consultant Anesthesia, Shaukat Khanum Memorial Cancer Hospital and Research Center , Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asad","family":"Aleem","sequence":"additional","affiliation":[{"name":"Resident Anesthesia, Shaukat Khanum Memorial Cancer Hospital and Research Center , Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"2026091908311142188_j_jcas-2026-0012_ref_001","doi-asserted-by":"crossref","unstructured":"Ramirez MF, Strang A, Roland G, Lasala J, Owusu-Agyemang P. Perioperative pain management and cancer outcomes: a narrative review. J Pain Res. 2023;16:4181\u201389.","DOI":"10.2147\/JPR.S432444"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_002","doi-asserted-by":"crossref","unstructured":"Hill BL, Lefkowits C. Strategies for optimizing perioperative pain management for the cancer patient. Surg Oncol Clin N Am. 2021;30(3):519\u201334.","DOI":"10.1016\/j.soc.2021.02.011"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_003","doi-asserted-by":"crossref","unstructured":"Heldreich C, Meyer I, Dube E, Hu R, Howard W, Holmes N, Maroon N, Weinberg L, Tan CO. Peri-Operative Pain Management, Education and De-escalation (POPPMED), a novel anaesthesiologist-led program, significantly reduces acute and long-term postoperative opioid requirements: a retrospective cohort study. Pain Reports. 2022 Sep 1;7(5):e1028.","DOI":"10.1097\/PR9.0000000000001028"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_004","unstructured":"Krtinic D, Nedin Rankovic G, Petkovic I, Cvetanovic A, Conic I, Todorovic Mitic M, et al. The role of tapentadol in cancer pain pharmacotherapy in patients with metastatic malignant disease. Eur Rev Med Pharmacol Sci. 2023;27:12112\u201320."},{"key":"2026091908311142188_j_jcas-2026-0012_ref_005","unstructured":"Takahara Y, Tanahashi J, Murota K, Imai M, Takagi Y, Kimata T. Efficacy of Tapentadol for Neuropathic Pain in Cancer. Gan To Kagaku Ryoho. 2021;48:811\u20134."},{"key":"2026091908311142188_j_jcas-2026-0012_ref_006","doi-asserted-by":"crossref","unstructured":"Wang X, Narayan SW, Penm J, Patanwala AE. Efficacy and safety of tapentadol immediate release for acute pain: a systematic review and meta-analysis. Clin J Pain. 2020;36(5):399\u2013409.","DOI":"10.1097\/AJP.0000000000000809"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_007","doi-asserted-by":"crossref","unstructured":"Viscusi ER, Allard R, Sohns M, Eerdekens M. Tapentadol immediate release for moderate to severe acute post-surgery pain. J Opioid Manag. 2019;15(1):51\u201367.","DOI":"10.5055\/jom.2019.0486"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_008","doi-asserted-by":"crossref","unstructured":"Pujol J, Mart\u00ednez-Vilavella G, Doreste A, Blanco-Hinojo L, Ojeda F, Llorente-Onaindia J, et al. Tapentadol effects on brain response to pain in sensitized patients with knee osteoarthritis. Rheumatology (Oxford). 2022;61(6):2335\u201345.","DOI":"10.1093\/rheumatology\/keab761"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_009","doi-asserted-by":"crossref","unstructured":"Alshehri FS. Tapentadol: a review of experimental pharmacology studies, clinical trials, and recent findings. Drug Des Devel Ther. 2023;17:851\u201361.","DOI":"10.2147\/DDDT.S402362"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_010","doi-asserted-by":"crossref","unstructured":"Eissa A, Tarau E, Beuter C, Radic T, Watson E, Sohns M, et al. Tapentadol for the treatment of moderate-to-severe acute pain in children under the age of two years. J Pain Res. 2021;14:229\u201348.","DOI":"10.2147\/JPR.S269530"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_011","doi-asserted-by":"crossref","unstructured":"Yadav G, Jain G, Samprathi A, Baghel A, Singh DK. Role of preventive tapentadol in reduction of perioperative analgesic requirements after laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2016;32(4):492\u20136.","DOI":"10.4103\/0970-9185.168257"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_012","doi-asserted-by":"crossref","unstructured":"Kulkarni VR, Sancheti R. A comparative study of effect of oral tapentadol versus oral gabapentin for postoperative pain relief in adult patients undergoing abdominal surgeries under general anaesthesia. MedPulse International Journal of Anesthesiology. January 2020; 13(1): 01\u201306","DOI":"10.26611\/10151311"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_013","doi-asserted-by":"crossref","unstructured":"Buynak R, Shapiro DY, Okamoto A, Van Hove I, Rauschkolb C, Steup A, Lange B, Lange C, Etropolski M. Efficacy and safety of tapentadol extended release for the management of chronic low back pain: results of a prospective, randomized, double-blind, placebo and active controlled phase III study. Expert Opin Pharmacother. 2010;11:1787\u2013804.","DOI":"10.1517\/14656566.2010.497720"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_014","unstructured":"Gupta A, Singh A, Ranjan P. Role of pre-emptive tapentadol in reduction of postoperative analgesic requirements after cholecystectomy. Int J Acad Med Pharm 2023;5(2):1631\u201336."},{"key":"2026091908311142188_j_jcas-2026-0012_ref_015","doi-asserted-by":"crossref","unstructured":"Safneedha PM, Raveena Ragavi CGV, Pughal Vendan G. To assess the role of nasal tapentadol as pre-emptive analgesia, in breast surgery patients. Int J Res Pharm Sci. 2024;15(3): 92\u20139.","DOI":"10.26452\/ijrps.v15i3.4702"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_016","doi-asserted-by":"crossref","unstructured":"Vadivelu N, Huang Y, Mirante B, Jacoby M, Braveman FR, Hines RL, et al. Patient considerations in the use of tapentadol for moderate to severe pain. Drug Healthc Patient Saf. 2013;3:151\u20139.","DOI":"10.2147\/DHPS.S28829"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_017","doi-asserted-by":"crossref","unstructured":"Hartrick CT, Rodr\u00edguez Hernandez JR. Tapentadol for pain: a treatment evaluation. Expert Opin Pharmacother. 2012;13(2): 283\u20136.","DOI":"10.1517\/14656566.2012.648616"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_018","doi-asserted-by":"crossref","unstructured":"Kleinert R, Lange C, Steup A, Black P, Goldberg J, Desjardins P. Single dose analgesic efficacy of tapentadol in postsurgical dental pain: the results of a randomized, double-blind, placebo-controlled study. Anesth Analg. 2008 Dec 1;107(6):2048\u201355.","DOI":"10.1213\/ane.0b013e31818881ca"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_019","doi-asserted-by":"crossref","unstructured":"Hartrick C, Van Hove I, Stegmann JU, Oh C, Upmalis D. Efficacy and tolerability of tapentadol immediate release and oxycodone HCl immediate release in patients awaiting primary joint replacement surgery for end-stage joint disease: A 10-day, phase III, randomized, double-blind, active- and placebo-controlled study. Clin Ther. 2009;31:260\u201371.","DOI":"10.1016\/j.clinthera.2009.02.009"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_020","doi-asserted-by":"crossref","unstructured":"Santos J, Alarc\u00e3o J, Fareleira F, Vaz-Carneiro A, Costa J. Tapentadol for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2015;5:CD009923.","DOI":"10.1002\/14651858.CD009923.pub2"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_021","doi-asserted-by":"crossref","unstructured":"Raffa RB, Elling C, Tzschentke TM. Does \u2018strong analgesic\u2019 equal \u2018strong opioid\u2019? Tapentadol and the concept of \u2018\u03bc load\u2019. Adv Ther. 2018;35:1471\u201384.","DOI":"10.1007\/s12325-018-0778-x"},{"key":"2026091908311142188_j_jcas-2026-0012_ref_022","doi-asserted-by":"crossref","unstructured":"Baron R, Eberhart L, Kern KU. Tapentadol prolonged release for chronic pain: a review of clinical trials and 5 years of routine clinical practice data. Pain Pract. 2017;17:678\u2013700.","DOI":"10.1111\/papr.12515"}],"container-title":["Journal of Cancer and Allied Specialties"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/jcas-2026-0012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T08:31:31Z","timestamp":1789806691000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/jcas-2026-0012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,1]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,6,29]]},"published-print":{"date-parts":[[2026,3,1]]}},"alternative-id":["10.2478\/jcas-2026-0012"],"URL":"https:\/\/doi.org\/10.2478\/jcas-2026-0012","relation":{},"ISSN":["2411-989X"],"issn-type":[{"value":"2411-989X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,1]]}}}