Journal Logo

Letters

Opioid Consumption after Plastic Surgery: Tailoring Opioid Administration to Patient Needs

Kendall, Mark C. M.D.

Author Information
Plastic and Reconstructive Surgery: January 2020 - Volume 145 - Issue 1 - p 216e-217e
doi: 10.1097/PRS.0000000000006237
  • Free

Sir:

I read with great interest the article by Rose et al. in a recent issue of the Journal.1 The authors studied 170 patients undergoing plastic surgery and concluded that plastic surgeons are prescribing almost double the amount of opioids consumed by patients after outpatient plastic surgery procedures. The authors should be applauded for performing a well-designed study regarding an important topic (e.g., acute pain) in patients undergoing plastic surgery.2,3 The need to reduce postoperative opioid consumption makes the topic very important in perioperative medicine.4,5

Nonetheless, there are several critical points that need to be clarified to determine the validity of the authors’ findings. First, it is unclear whether the authors validated their measurement of opioid consumption by using accepted methodologies such as “pill counts” or more sophisticated device technologies.6 Finally, it would be important for the authors to predict the patient and surgical factors that lead to opioid use after plastic surgery using a multivariate analysis. This would inform clinical practitioners on how to tailor their opioid-prescribing practices.

I would welcome comments to address the aforementioned issues, as they were not discussed by the authors. This would help to further support the findings of this important study.

DISCLOSURE

The author has no financial interest to declare in relation to the content of this communication. No funding was provided.

REFERENCES

1. Rose KR, Christie BM, Block LM, Rao VK, Michelotti BF. Opioid prescribing and consumption patterns following outpatient plastic surgery procedures. Plast Reconstr Surg. 2019;143:929–938.
2. Osaka Y, Morita Y. Supraclavicular brachial plexus block is an alternative to pectoral nerve block 1 for contracture reconstruction post mastectomy. J Clin Anesth. 2018;46:12.
3. Kelley BP, Chung KC, Chung TT, et al. Postoperative ketorolac in breast and body contouring procedures: A nationwide claims analysis. Plast Reconstr Surg. 2018;142:472e–480e.
4. Tong QJ, Lim YC, Tham HM. Comparing adductor canal block with local infiltration analgesia in total knee arthroplasty: A prospective, blinded and randomized clinical trial. J Clin Anesth. 2018;46:39–43.
5. Ueshima H, Otake H. Blocking of multiple posterior branches of cervical nerves using an erector spinae plane block. J Clin Anesth. 2018;46:44.
6. Tomko RL, McClure EA, Squeglia LM, et al. Methods to reduce the incidence of false negative trial results in substance use treatment research. Curr Opin Psychol. 2019;30:35–41.

GUIDELINES

Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article’s publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor.

Letters submitted should pose a specific question that clarifies a point that either was not made in the article or was unclear, and therefore a response from the corresponding author of the article is requested.

Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS’ enkwell, at www.editorialmanager.com/prs/.

We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and asignees to publish it in the Journal and in any other form or medium.

The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.

The Journal requests that individuals submit no more than five (5) letters to Plastic and Reconstructive Surgery in a calendar year.

Copyright © 2019 by the American Society of Plastic Surgeons