Decreased postoperative pain and opioid use following prepectoral versus subpectoral breast reconstruction after mastectomy: A retrospective cohort study: Pain after pre- versus subpectoral reconstruction.
J Plast Reconstr Aesthet Surg
; 74(8): 1763-1769, 2021 Aug.
Article
en En
| MEDLINE
| ID: mdl-33451949
ABSTRACT
BACKGROUND:
Prepectoral (PP) breast reconstruction is now commonly performed and minimizes dissection of the pectoralis major muscle. Data are lacking comparing the immediate postoperative recovery of these patients as compared with traditional subpectoral (SP) breast reconstruction.METHODS:
From December 2015 to February 2017, 73 patients underwent PP prosthetic-based reconstruction at a single academic institution. PP cases were matched 11, by age and stage, to patients undergoing traditional SP reconstruction. Analysis of postoperative pain (visual analog scale) and opioid use (oral morphine equivalents, OME), was performed with both bi- and multivariate analyses. Additional outcomes explored included length of stay (LOS) and reconstructive intervention by plane of prosthetic reconstruction.RESULTS:
A total of 146 patients were included in the final cohort. PP reconstruction was associated with higher rates of direct-to-implant reconstruction (84.9% vs. 34.3%, p <0.001) and higher rates of initial prosthetic fill (401.53â¯mL vs. 280.88â¯mL, p<0.001). Patients undergoing PP reconstruction had significantly reduced postoperative pain (4.29â¯vs. 5.44, p<0.001) and in-hospital opioid use (62.63â¯mg OME vs. 98.84â¯mg OME, pâ¯=â¯0.03) compared with SP patients. This result remained in multivariate analysis for both pain (3.94â¯vs. 5.25, p<0.001) and opioid use (17.14â¯mg OME vs. 63.03â¯mg OME, pâ¯=â¯0.03). Additionally, patients undergoing PP reconstruction had significantly reduced overall LOS on multivariate analysis (21.36â¯vs. 26.28 h, pâ¯=â¯0.02).CONCLUSION:
Following mastectomy, PP breast reconstruction results in significantly reduced pain, opioid use, and hospital LOS compared with SP reconstruction.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
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Músculos Pectorales
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Neoplasias de la Mama
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Mamoplastia
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Analgésicos Opioides
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Female
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Humans
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Middle aged
Idioma:
En
Año:
2021
Tipo del documento:
Article