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Enhanced Recovery After Surgery (ERAS) protocols decrease outpatient opioid use in patients undergoing abdominally based breast reconstruction
Juan L. Rendon, MD, PhD
Roman J. Skoracki, MD
Albert H. Chao, MD
The Ohio State University
2019-02-02
Presenter: Juan L. Rendon, MD, PhD
Affidavit:
Juan L. Rendon contributed greater than 50% effort to work presented in this abstract.
Director Name: Gregory Pearson, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background:
Enhanced Recovery After Surgery (ERAS) protocols are now commonly used in patients undergoing abdominally based microsurgical breast reconstruction. These protocols have been shown to decrease inpatient opioid use and length of hospital stay. However, little is known about the impact of ERAS protocols on outpatient recovery. The objective of this study was to evaluate the effects of an ERAS protocol implementation on outpatient recovery following abdominally based microsurgical breast reconstruction.
Methods:
A retrospective review of patients who underwent abdominally based breast reconstruction before and after implementation of ERAS at our institution was performed.
Results:
A total of 105 patients met inclusion criteria, of which 59 (56%) were in the ERAS group and 46 (44%) were in the non-ERAS group. There were not any significant differences between the two groups with respect to age (p=0.06), BMI (p=0.32), laterality (unilateral versus bilateral, p=0.29), or concurrent lymphadenectomy (p=0.69). A significant difference was identified in overall outpatient opioid use, which was less in the ERAS compared to the non-ERAS group (391.0 versus 606.9 Morphine Milligram Equivalents, respectively; p=0.007). A significant difference was also identified in pain scores at the first postoperative visit, which was less in the ERAS compared to the non-ERAS group (1.6 versus 3.6, respectively; p=0.016).
Conclusions:
The beneficial effects of ERAS in patients undergoing abdominally based microsurgical breast reconstruction appear to extend beyond the inpatient setting, resulting in decreased opioid requirements and pain in the outpatient setting.
