modulation of microrna-133b in post mastectomy pain syndrome following yoga intervention

Objectives: this study aimed to compare the efficacy of yoga combined with an integrated multimodal approach on the incidence and severity of post-mastectomy pain syndrome (pmps) and the role of mir-133b expressions in patients undergoing breast cancer surgery. methods: with approval from the institutional ethics committee and informed consent obtained from each participant, forty patients of asa grade i - ii, aged 20 - 65 years, undergoing breast cancer surgery were included. patients received a thoracic paravertebral block for up to 72 hours and pregabalin until the end of the fourth postoperative week. patients were randomly allocated into two groups: “control” and “yoga.” patients in the yoga group practiced the yogic exercise “anulom-vilom from the third day until the 90th day postoperatively. the delta-ct of mirna-133b expression of genes on the 90th postoperative day was compared to the baseline, along with various pain intensity and quality of life parameters. results: in the yoga group, a significant up-regulation in mir-133b expression was observed on days 30 and 90 postoperatively. patients with pmps in the yoga group showed a decreased δct of mir-133b, indicating an up-regulation of gene expression, compared to the control group. a lower incidence of pmps (10% vs. 30%) was observed in the experimental group, along with a significant enhancement of quality of life in post-mastectomy patients and decreased mean visual analogue scale (vas) pain scores, pain detect questionnaire (pdq) ، andneuropathic pain symptom inventory (npsi) scores in the yoga group; however, these were not statistically significant. conclusions: the study demonstrated the feasibility of integrating yoga with a multimodal pain management approach and highlighted the role of mir-133b in the pathogenesis of pmps.