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Stromal Vascular Fraction-enriched Fat Grafting for the Treatment of Symptomatic End-neuromata
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Long-Term Opioid Use After Free Flap Breast Reconstruction: Incidence and Associated Factors
Joshua B Cadwell1, Minji Kim2, Francis D Graziano2
1Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Plastic Surgery (Oakville, Ont.)
|January 29, 2025
Summary
Only 2% of breast reconstruction patients experienced prolonged opioid dependence after free flap surgery. Risk factors include higher intraoperative opioid doses and prior substance use disorders, highlighting the need for continued opioid-sparing strategies.
Area of Science:
- Plastic Surgery
- Oncology
- Pain Management
Background:
- Opioid dependence affects 6-10% of patients post-breast reconstruction.
- Interdisciplinary efforts aim to reduce postoperative opioid use.
- Updated data on prolonged opioid dependence after free flap breast reconstruction is needed.
Purpose of the Study:
- To determine the incidence of prolonged opioid dependence after free flap breast reconstruction.
- To identify risk factors associated with prolonged opioid use in this patient population.
Main Methods:
- Retrospective review of free flap breast reconstructions from 2017-2020.
- Exclusion of patients with additional surgeries within 120 days.
- Definition of prolonged opioid use as prescriptions 91-120 days post-surgery.
- Logistic regression analysis to assess risk factors.
Main Results:
- 15 out of 732 patients (2%) exhibited prolonged opioid use.
- Significant associations found with intraoperative morphine, later opioid prescriptions, and history of substance use disorder, anxiety, or mood disorder.
Conclusions:
- Prolonged opioid use occurred in 2% of patients undergoing autologous breast reconstruction.
- Current opioid minimization initiatives may benefit patients undergoing these procedures.
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