Reducing Narcotic Prescriptions in Breast Surgery: A Prospective Analysis.

Area of Science:

• Oncology
• Surgical Oncology
• Pain Management

Background:

• Postoperative pain control standards for breast surgery are not well-defined.
• Opioid prescribing patterns vary significantly.
• There is a need to optimize opioid use after breast cancer surgery.

Purpose of the Study:

• To review and adjust opioid prescribing practices for breast surgery patients.
• To evaluate the effectiveness of a departmental practice change.
• To prospectively assess actual patient narcotic usage post-discharge.

Main Methods:

• Reviewed narcotic prescriptions for 100 consecutive breast surgery patients to establish baseline patterns.
• Implemented a planned change in prescribing practices based on median prescribed amounts.
• Prospectively collected data on patient narcotic usage using a standardized template.

Main Results:

• Prescribed narcotic median decreased significantly after departmental education (e.g., excisional biopsy/lumpectomy from 15 to 10 pills).
• Actual patient usage was substantially lower than prescribed amounts (e.g., excisional biopsy/lumpectomy patients used a median of 1 pill).
• Only three patients required narcotic refills, all with breast reconstruction.

Conclusions:

• Opioid prescriptions for breast surgery can be successfully reduced through practice adjustments.
• Prospective patient usage data suggest further reductions in opioid prescriptions are feasible.
• Optimizing opioid prescribing can improve postoperative pain management and reduce excess medication.