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Bilateral Breast Reduction Without Opioid Analgesics: A Comparative Study.

Fereydoun Don Parsa1, Justin Cheng1, Brad Stephan1

  • 1Department of Surgery, Division of Plastic Surgery, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI. Department of Surgery, Division of Plastic Surgery, Rutgers New Jersey Medical School, Newark, NJ. Department of Plastic Surgery, University of Virginia Health System, Charlottesville, VA. Department of Medicine, University of Hawaii, John A Burns School of Medicine, Honolulu, HI.

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Summary
This summary is machine-generated.

This study demonstrates that an opioid-free multimodal pain management approach significantly reduces recovery time and hospital admissions for breast reduction surgery. This innovative method offers a safer alternative to traditional opioid-based anesthesia, improving patient outcomes.

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Area of Science:

  • Plastic Surgery
  • Anesthesiology
  • Pain Management

Background:

  • Traditional breast reduction often involves general anesthesia and opioid use, which carry significant risks.
  • Opioids can cause adverse effects like nausea, vomiting, constipation, sedation, dizziness, and addiction.

Purpose of the Study:

  • To compare a multimodal opioid-free pain management regimen with traditional opioid-based anesthesia for bilateral breast reduction.
  • To evaluate the safety and efficacy of opioid-free breast reduction techniques.

Main Methods:

  • 83 female patients underwent bilateral breast reduction.
  • Group 1 (retrospective, n=39) received general anesthesia with opioids.
  • Groups 2 (prospective, n=26) and 3 (prospective, n=18) received opioid-free multimodal pain management (gabapentin, celecoxib, local anesthetics) under IV sedation/local anesthesia or general anesthesia, respectively.

Main Results:

  • Opioid-free groups (2 and 3) showed a significantly shorter time from surgery end to home discharge (P < 0.05).
  • Fewer unplanned hospital admissions were observed in the opioid-free groups (P < 0.05).
  • A highly significant decrease in postoperative opioid use was noted in groups 2 and 3 (P < 0.001).

Conclusions:

  • A multimodal opioid-free approach enables safe outpatient bilateral breast reduction under local or general anesthesia.
  • This method significantly reduces morbidity, postoperative opioid use, and unplanned hospital admissions compared to traditional opioid-based procedures.