Reducing opioid prescribing after ambulatory breast reconstruction surgery

Area of Science:

• Plastic Surgery
• Pain Management
• Pharmacology

Background:

• Lack of evidence-based guidelines for postoperative opioid prescriptions after breast reconstruction leads to practice variation.
• This variation increases the potential for opioid misuse and abuse.

Purpose of the Study:

• To evaluate the feasibility and impact of a standardized opioid prescription reduction initiative for breast reconstruction patients.
• To assess changes in opioid use, pain control, and patient-reported outcomes.

Main Methods:

• A survey was conducted before (n=97) and after (n=101) implementing a standardized opioid prescription reduction initiative for outpatient breast reconstruction.
• Postoperative opioid use, pain control (Recovery Tracker), and physical wellbeing (BREAST-Q) were compared between the two groups.

Main Results:

• Median prescribed opioid pills decreased from 30 to 8.
• Actual opioid consumption remained stable at 3 pills in both groups.
• No significant difference was observed in moderate to very severe pain or early BREAST-Q physical wellbeing scores.

Conclusions:

• Standardizing and reducing opioid prescriptions for breast reconstruction is feasible and effectively decreases excess pills.
• The initiative showed no adverse impact on early physical wellbeing.
• Larger studies are recommended for further data acquisition.