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Updated: Jan 21, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Mastectomy is no longer an indication for postoperative opioid prescription at discharge
Kristin E Rojas1, Thais A Fortes1, Peter L Flom2
1Maimonides Medical Center Department of Surgery, 4802 Tenth Avenue, Brooklyn, NY, 11219, United States.
Background:
A 10-step protocol employing multimodal analgesia was implemented in patients undergoing mastectomy to decrease the quantity of opioids prescribed at discharge.
Methods:
Patients who received the Enhanced Recovery After Surgery (ERAS) protocol were compared to a control group. Inpatient and discharge prescription of opioids were compared using oral morphine equivalents (OMEs), along with postoperative pain scores.
Results:
Between 2017 and 2018, fifty-seven patients were eligible for inclusion: 20 patients received ERAS and 37 received usual care (UC). The ERAS group received a mean of 2.4 (0-13) inpatient OMEs and the UC group received 13.7 (0-80) (p = 0.002). The ERAS group received 2.0 (0-40) OMEs at discharge and the UC group received 59.8 (0-120) (p < 0.001). Postoperative pain scores were significantly lower in the patients who received the ERAS protocol.
Conclusions:
Patients who received the ERAS protocol required less postoperative opioids and reported lower pain scores when compared to a control group.
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