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Opioid Use in Breast Reconstruction

Mann, Sara BS; Scheefer, Melody MD; Veith, Jacob MD; Collier, Willem H BS; Agarwal, Jayant MD; Kwok, Alvin MD, MPH

Plastic and Reconstructive Surgery – Global Open: July 2019 - Volume 7 - Issue 7S - p 4
doi: 10.1097/01.GOX.0000579808.87067.06
Mountain West 2019 Abstract Supplement

University of Utah, Salt Lake City, UT

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

INTRODUCTION: Little is known about opioid use in breast cancer patients undergoing placement of a tissue expander (TE) for breast reconstruction. In this patient population we sought to characterize the amount of opioids used, the duration of opioid use, and possible procedural and patient characteristics associated with increased opioid use.

METHODS: We recruited consecutive breast cancer patients undergoing the placement a TE for breast reconstruction. Each patient was given a Postoperative Pain Medication Logbook (PPML) and was instructed to document the quantity and type of pain medication used during the 28 days after discharge. We assessed total morphine milligram equivalents used and days to opioid cessation. Simple linear regression was used to compare demographic and clinical characteristics to each of these outcomes at the patient level. Recruitment is ongoing.

RESULTS: Nineteen patients have completed their PPML thus far. The mean days to opioid cessation was 8.1 and the average number of Oxycodone 5 mg tablets used was 17.1. On average, each patient had 26.4 tablets of Oxycodone 5 mg prescribed. Most patients only used 65% of their prescribed opioids. Neither prepectoral (p=0.60) or bilateral (p=0.32) reconstruction had a statistically significant effect on the amount of opioid used. There was a trend towards more days to opioid cessation in patients who had larger amounts of opioids prescribed at discharge (correlation = 0.15)

CONCLUSION: On average, patients undergoing TE placement for breast reconstruction needed less opioids than they were prescribed. Additional research is needed to optimize opioid prescribing habits after breast reconstruction.

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.