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

IF 2.2 3区 医学 Q2 SURGERY
Journal of reconstructive microsurgery Pub Date : 2024-11-01 Epub Date: 2024-03-07 DOI:10.1055/a-2283-4775
Jessica L Marquez, Josh Chow, Whitney Moss, Jessica Luo, Devin Eddington, Jayant P Agarwal, Alvin C Kwok
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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.

接受和未接受教育干预的 DIEP 乳房再造术患者出院后的阿片类药物门诊处方使用情况。
导言:关于自体乳房再造术后适当使用阿片类药物的证据有限。我们试图描述下腹穿孔器(DIEP)乳房再造术后出院时使用和未使用教育视频的术后门诊处方阿片类药物的情况:从 2022 年 8 月到 2023 年 6 月,对接受 DIEP 重建术的患者进行了为期 28 天的术后疼痛和用药记录。我们在患者出院时播放了关于正确使用阿片类药物的教育视频。我们对两组患者的特征、术中和术后阿片类药物消耗量以及出院后门诊处方阿片类药物使用情况进行了描述性统计比较:共完成了 53 份日志,其中无视频队列中有 20 名患者,有视频队列中有 33 名患者。平均而言,无视频队列中停止使用阿片类药物的天数更长(8.2 天对 5.1 天,P=0.003)。无视频队列在出院后平均消耗的 5 毫克羟考酮当量为 13.8 毫克,有视频队列为 7.8 毫克,差异有统计学意义(P=0.01)。总体而言,视频队列中处方阿片类药物的消耗比例为 28.3%,而无视频队列中为 67.1%:结论:对于 DIEP 重建术后出院回家的患者,我们建议处方 12 片 5 毫克的羟考酮。通过使用关于正确使用阿片类药物的教育视频,我们能够将出院后门诊阿片类药物的总用量减少到五片 5 毫克羟考酮。
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来源期刊
CiteScore
4.50
自引率
28.60%
发文量
80
审稿时长
1 months
期刊介绍: The Journal of Reconstructive Microsurgery is a peer-reviewed, indexed journal that provides an international forum for the publication of articles focusing on reconstructive microsurgery and complex reconstructive surgery. The journal was originally established in 1984 for the microsurgical community to publish and share academic papers. The Journal of Reconstructive Microsurgery provides the latest in original research spanning basic laboratory, translational, and clinical investigations. Review papers cover current topics in complex reconstruction and microsurgery. In addition, special sections discuss new technologies, innovations, materials, and significant problem cases. The journal welcomes controversial topics, editorial comments, book reviews, and letters to the Editor, in order to complete the balanced spectrum of information available in the Journal of Reconstructive Microsurgery. All articles undergo stringent peer review by international experts in the specialty.
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