An Analgesic Regimen for Opioid Reduction in Elective Plastic Surgery: A Randomized Prospective Study

Area of Science:

• Pain Management
• Surgical Recovery
• Public Health

Background:

• Prescription opioid misuse is a national epidemic, with significant implications for surgical patients.
• Postoperative opioid abuse can lead to addiction, highlighting the need for alternative pain management strategies.
• Enhanced Recovery After Surgery (ERAS) protocols are increasingly adopted to mitigate excessive postoperative opioid use.

Purpose of the Study:

• To prospectively evaluate the efficacy of a multimodal (ERAS) analgesia regimen versus traditional opioid analgesia.
• To compare postoperative pain scores, opioid consumption, and duration of pain pill use between the two groups.

Main Methods:

• 143 patients undergoing elective cosmetic surgery were randomized into two groups: multimodal (ERAS) analgesia or traditional opioid analgesia.
• Data collected included postoperative pain scores, opioid quantity consumed, and duration of pain medication use.
• Statistical analysis was performed to compare outcomes between the groups.

Main Results:

• ERAS patients showed a significant reduction in pain scores post-anesthesia care unit admission (13.0%) and at discharge (34.2%) compared to traditional opioid patients (p=0.049 and p=0.0036).
• ERAS patients consumed 35% fewer opioid pills and used them for 18.4% less time postoperatively (p=0.0007 and p=0.0539).

Conclusions:

• Multimodal postoperative pain management, utilizing ERAS principles, effectively decreases opioid prescription and consumption.
• Reducing postoperative opioid use is crucial to prevent abuse and curb the expansion of the national opioid reservoir.