Can explicit pain management instructions reduce opioid use following elective breast reduction surgery?
Logan Erz, MD
Douglas Wagner, MD
Shayda Mirhaidari, MD
Presenter: Logan Erz
I certify that Logan Erz has completed approximately 75% of the original work on this project.
Director Name: Douglas Wagner, MD
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
The purpose of this study was to determine if a more regulated pain management instruction plan could reduce the number of opioids taken when compared to generic pain management instructions without compromising pain control.
This was a randomized prospective study comparing a total of 80 (Group A=40, Group B=40) women undergoing elective outpatient bilateral breast reduction surgery by two different plastic surgeons. Patients were randomly divided into either Group A (control) that received general pain management instructions or Group B (experimental) that received explicit pain management instructions. Participants were asked to record the number of times they treated their pain with each separate modality and their daily pain score.
Group B that received explicit pain management instructions took on average less oxycodone than their comparison in Group A. Participants in Group B took on average two (1.7, SD+/- 3.79) oxycodone tabs. 25 patients in group B took zero oxycodone. While patients in Group A took on average five (5.22, SD+/-5.56) oxycodone tabs post-operatively (p<0.01). Only 7 patients in group took no oxycodone tabs. There was also a statistically significant difference in subjective pain scores between Group A and Group B (p=0.01). Patients in Group B had lower subjective pain scale scores on average (3.51, SD+/-1.51) when compared to Group A (4.48, SD+/-1.8).
Based on these results it appears that standardizing how patients are instructed to treat their pain post-operatively may reduce the number of narcotics needed, thus reducing the number of narcotics prescribed without compromising pain control.
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