A prospective study of opioid use for postoperative pain management after breast operation

Am J Surg. 2020 Jan;219(1):8-14. doi: 10.1016/j.amjsurg.2019.07.032. Epub 2019 Jul 25.

Abstract

Background: The opioid epidemic has necessitated increased attention to prescribing practices. This study seeks to prospectively quantify postoperative opioid use after breast operation.

Methods: Consecutive patients undergoing breast operation at a single institution in 2018 prospectively tracked each dose of medication and completed a survey of perceptions regarding their opioid prescription.

Results: Of 100 patients, 88 completed log, survey, or both. The tab quantity required to fulfill the needs of 80% of patients was: Partial mastectomy (PM) 3, PM with sentinel lymph node biopsy 6, PM with bilateral reduction 8, total mastectomy 34, and bilateral mastectomy 47. Of survey respondents, 51.2% felt they had been prescribed too much pain medication. Most (83.0%) had leftover tabs, and 67.9% indicated they kept them in their home.

Conclusions: The majority of patients were overprescribed opioids after breast operation. A reduction could be achieved by targeting the needs of 80% of the population.

Keywords: Breast; Lumpectomy; Mastectomy; Opioid; Postoperative analgesia.

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use*
  • Drug Utilization / statistics & numerical data*
  • Female
  • Humans
  • Mastectomy*
  • Middle Aged
  • Pain Management / methods*
  • Pain, Postoperative / drug therapy*
  • Prospective Studies
  • Self Report

Substances

  • Analgesics, Opioid