Perioperative Blocks for Decreasing Postoperative Narcotics in Breast Reconstruction

Area of Science:

• Anesthesiology
• Plastic Surgery
• Pain Management

Background:

• Opioid medications are frequently overused post-surgery, leading to high mortality and dependence rates.
• Enhanced Recovery After Surgery (ERAS) guidelines promote local anesthesia to reduce opioid needs.
• Breast reconstruction surgery often requires significant pain management, increasing opioid reliance.

Purpose of the Study:

• To review effective perioperative nerve blocks for decreasing opioid use after breast reconstruction.
• To summarize evidence on local anesthetic techniques in breast reconstruction pain management.

Main Methods:

• A comprehensive literature review was performed.
• Keywords included: narcotics, opioid, surgery, breast reconstruction, pain pump, nerve block, regional anesthesia, and analgesia.
• Included studies focused on local anesthetic options for reducing postoperative narcotic consumption in breast reconstruction.

Main Results:

• 52 papers were included in the review.
• Effective local anesthetic options include single-shot nerve blocks, nerve block catheters, and regional anesthesia.
• Most studies reported equivalent or superior pain control, with reduced nausea, vomiting, and shorter hospital stays.

Conclusions:

• Local anesthetic techniques significantly reduce narcotic use in breast reconstruction patients.
• Implementing these strategies can lead to improved patient outcomes compared to traditional opioid-based pain management.
• Nerve blocks and regional anesthesia offer a viable alternative to opioids for postoperative pain control.