Enhanced Recovery Minimizes Opioid Use and Hospital Stay for Patients Undergoing  Mastectomy with Reconstruction.

Enhanced Recovery Minimizes Opioid Use and Hospital Stay for Patients Undergoing  Mastectomy with Reconstruction.

McGugin et al. Enhanced Recovery Minimizes Opioid Use and Hospital Stay for Patients Undergoing
Mastectomy with Reconstruction. Ann Surg Oncol. 2019 Oct;26(11):3464-3471.

What is already known:

With the current opioid crisis and possible association with cancer recurrence plus all the other known side effects of their use, reducing the amount of opioids used perioperatively can only be beneficial.

What this paper adds:

In this study the authors conduct a retrospective observational cohort study. They compared a contemporary group with a historical pre-ERAS cohort group. All patients received a paravertebral block as part of their analgesic plan. Compared with the historical cohort, the patients undergoing mastectomy in the contemporary cohort were 26% less likely to require IV opioids and had a significantly decreased LOS. Even after adjustment for increasing rates of Nipple-Sparing Mastectomy and direct implant reconstruction over time, opioid use and LOS still were associated with the ERAS group and multimodal analgesia use.

Chris Jones, Guildford.