Association of Regional Anesthesia With Reduced Post-discharge Opioid Prescriptions Following Immediate Autologous Breast Reconstruction: An ACS-NSQIP Analysis

IF 2.7 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2026-08-01 Epub Date: 2026-07-09 DOI:10.1016/j.clbc.2026.07.008

Dylan K. Kim, Millicent M. Warner, Ashley Zhang, Jarrod T. Bogue

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引用次数: 0

Abstract

Background

Postoperative pain may be significant following mastectomy and immediate autologous breast reconstruction, and pain management regimens must be balanced with opioid stewardship. Regional anesthesia has been associated with reduced opioid consumption in smaller studies and may represent a promising method of acute pain management. This study evaluates rates of opioid prescription and renewal following immediate autologous reconstruction depending on receipt of regional anesthesia.

Methods

All adult female patients who underwent immediate autologous breast reconstruction in the 2024 National Surgical Quality Improvement Program dataset were identified. Patient cohorts who did and did not receive regional anesthesia were propensity score-matched in a 1:2 ratio. Rates of post-discharge opioid prescriptions and subsequent renewals were compared between cohorts (P < .05).

Results

The final cohort included 1103 patients. Regional anesthesia was utilized in 231 (20.9%) cases, and the rate of post-discharge opioid prescription was 60.8% (671 patients). After matching on covariates like body mass index, operative time, and local anesthesia utilization (n = 684), regional anesthesia usage was associated with significantly lower rates of opioid prescriptions (57.0% vs. 66.4%; P = .020) and conferred lower odds of opioid prescription in multivariable analysis (OR: 0.71, 95% CI: 0.51-0.99; P = .041). Among patients who were prescribed opioids, the rate of renewal was similar between matched cohorts (6.6% vs. 6.2%; P = 1.00).

Conclusion

Regional anesthesia was associated with reduced post-discharge opioid prescriptions and similar rates of prescription renewal following immediate autologous breast reconstruction. These findings support the further investigation and possible integration of regional anesthesia within pain management regimens for autologous breast reconstruction.

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区域麻醉与立即自体乳房重建术后出院后阿片类药物处方减少的关系：ACS-NSQIP分析。

背景：乳房切除术和立即自体乳房重建术后疼痛可能很明显，疼痛管理方案必须与阿片类药物管理相平衡。在小型研究中，区域麻醉与减少阿片类药物消耗有关，可能是一种有前途的急性疼痛管理方法。本研究评估阿片类药物处方率和更新后立即自体重建依赖于接受区域麻醉。方法：选取2024年国家外科质量改进计划数据集中所有接受立即自体乳房重建的成年女性患者。接受和未接受区域麻醉的患者队列以1:2的比例进行倾向评分匹配。比较各组之间出院后阿片类药物处方率和随后的续订率（P < 0.05）。结果：最终队列包括1103例患者。区域麻醉231例（20.9%），出院后阿片类药物处方率60.8%（671例）。在匹配协变量如体重指数、手术时间和局麻使用率（n = 684）后，在多变量分析中，局麻使用率与阿片类药物处方率显著降低相关（57.0%对66.4%;P = 0.020），并与阿片类药物处方率降低相关（OR: 0.71, 95% CI: 0.51-0.99; P = 0.041）。在处方阿片类药物的患者中，配对队列之间的更新率相似（6.6%对6.2%;P = 1.00）。结论：区域麻醉与出院后阿片类药物处方减少有关，并与立即自体乳房重建后处方更新率相似。这些发现支持进一步的研究和区域麻醉在自体乳房再造术疼痛管理方案中的可能整合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.