Mastectomy is no longer an indication for postoperative opioid prescription at discharge.

Abstract

BACKGROUND\nA 10-step protocol employing multimodal analgesia was implemented in patients undergoing mastectomy to decrease the quantity of opioids prescribed at discharge.\n\n\nMETHODS\nPatients who received the Enhanced Recovery After Surgery (ERAS) protocol were compared to a control group. Inpatient and discharge prescription of opioids were compared using oral morphine equivalents (OMEs), along with postoperative pain scores.\n\n\nRESULTS\nBetween 2017 and 2018, fifty-seven patients were eligible for inclusion: 20 patients received ERAS and 37 received usual care (UC). The ERAS group received a mean of 2.4 (0-13) inpatient OMEs and the UC group received 13.7 (0-80) (p\u202f=\u202f0.002). The ERAS group received 2.0 (0-40) OMEs at discharge and the UC group received 59.8 (0-120) (p\u202f<\u202f0.001). Postoperative pain scores were significantly lower in the patients who received the ERAS protocol.\n\n\nCONCLUSIONS\nPatients who received the ERAS protocol required less postoperative opioids and reported lower pain scores when compared to a control group.