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
