Patient-reported opioid use for tissue expander-based breast reconstruction

Area of Science:

• Plastic Surgery
• Pain Management
• Oncology

Background:

• Limited evidence exists for appropriate post-operative opioid prescribing guidelines in breast reconstruction patients.
• Understanding opioid use patterns is crucial for minimizing dependence, misuse, and diversion.

Purpose of the Study:

• To describe postoperative outpatient prescription opioid use patterns (quantity and duration) following discharge after immediate breast reconstruction with tissue expanders (TE).
• To identify demographic and/or clinical risk factors associated with postoperative outpatient opioid use.

Main Methods:

• Patients undergoing immediate TE-based breast reconstruction completed 28-day postoperative pain medication logbooks.
• Descriptive statistics analyzed opioid quantity and duration.
• Preoperative, intraoperative, and postoperative characteristics were examined for associations with opioid use.

Main Results:

• Average outpatient opioid use was 7.42 days, with an average consumption of 15.9 oxycodone 5 mg tablets.
• Higher inpatient opioid consumption was associated with increased post-discharge opioid use.
• Older age was associated with a shorter duration of opioid use post-discharge.

Conclusions:

• Patient-reported data provide a benchmark for plastic surgeons to minimize narcotic use and prevent opioid-related issues.
• Recommended outpatient opioid prescriptions are 10 oxycodone 5 mg tablets, or 15 for younger patients (<49) or those with high inpatient use.
• Expected outpatient opioid duration is 7-11 days; 20% of patients did not require opioids post-discharge, suggesting potential for nonnarcotic regimens.