Variability in Opioid Prescribing Among Plastic Surgery Residents After Bilateral Breast Reduction.

Area of Science:

• Plastic Surgery
• Pain Management
• Opioid Prescribing Practices

Background:

• Opioid misuse leads to significant morbidity and mortality in the US.
• Over one-third of surgeon-prescribed medications are opioids.
• Lack of guidelines in plastic surgery contributes to variable and excessive opioid prescriptions.

Purpose of the Study:

• To understand opioid prescribing patterns among plastic surgery residents.
• To identify factors influencing opioid prescriptions after bilateral breast reduction.
• To inform the development of safer opioid prescribing models.

Main Methods:

• Retrospective analysis of 126 bilateral breast reduction cases (2018-2021).
• Evaluation of prescribing patterns by resident, postgraduate year, attending surgeon, and patient characteristics.
• Statistical analysis including ANOVA and multivariate analysis.

Main Results:

• Significant variability in opioid prescribing among residents (P < 0.001).
• Resident status was the primary predictor of opioid prescription volume (P < 0.001).
• Junior residents prescribed higher morphine milligram equivalents than senior residents (P < 0.001).

Conclusions:

• Variable and excessive opioid prescribing necessitates early opioid education in surgical training.
• Improved oversight and communication between residents and attending surgeons are crucial.
• Evidence-based, opioid-conscious analgesic protocols can standardize prescriptions and enhance patient safety.