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J Reconstr Microsurg
DOI: 10.1055/a-2283-4775
Original Article

Outpatient Prescription Opioid Use following Discharge after Deep Inferior Epigastric Perforator Breast Reconstruction with and without an Educational Intervention

Jessica L. Marquez 
1   Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah
,
Josh Chow
1   Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah
,
Whitney Moss
1   Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah
,
Jessica Luo
1   Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah
,
Devin Eddington
2   Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah
,
Jayant P. Agarwal
1   Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah
,
Alvin C. Kwok
1   Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah
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Abstract

Background There is limited evidence for appropriate postoperative opioid prescribing in autologous breast reconstruction. We sought to describe postoperative outpatient prescription opioid use following discharge after deep inferior epigastric perforator (DIEP) breast reconstruction with and without an educational video.

Methods Patients undergoing DIEP reconstruction were given a 28-day postoperative pain and medication logbook from August 2022 to June 2023. Our practice implemented an educational video upon discharge on proper opioid consumption. Descriptive statistics on patient characteristics, intraoperative and postoperative opioid consumption, and outpatient prescription opioid use after discharge were compared between the two cohorts.

Results A total of 53 logbooks were completed with 20 patients in the no video cohort and 33 in the video cohort. On average, the days to cessation of opiates was longer in the no video cohort (8.2 vs. 5.1 days, p = 0.003). The average number of oxycodone 5 mg equivalents consumed following discharge was 13.8 in the no video cohort and 7.8 in the video cohort, which was statistically significant (p = 0.01). Overall, the percentage of opioids prescribed that were consumed in the video cohort was 28.3% versus 67.1% in the no video cohort.

Conclusion For patients discharging home after DIEP reconstruction, we recommend a prescription for 12 oxycodone 5 mg tablets. With the use of an educational video regarding proper opioid consumption, we were able to reduce the total outpatient opioid use to 5 oxycodone 5 mg tablets following hospital discharge.

Keywords

opioid prescribing guidelines - breast reconstruction - postoperative opioids - postoperative pain control

Author Contributions

All authors above appropriately contributed to the development of this manuscript. The conceptualization of the goals/aims of the article were driven by J.P.A. and A.C.K. The formal acquisition of the data was carried out by J.L.M., J.C., W.M., and J.L. Data analysis was conducted by D.E. J.M., J.C., W.M., J.P.A., and A.C.K. were involved in drafting and revising the final version for submission.


Supplementary Material



Publication History

Received: 23 December 2023

Accepted: 20 February 2024

Accepted Manuscript online:
07 March 2024

Article published online:
26 March 2024

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