Association of preoperative opioid use and postoperative complications following breast reconstruction.

Autor: Cheah MA; Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA; Department of Plastic and Reconstructive Surgery, UT Southwestern, Dallas, TX 75390, USA., Sarmiento S; Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA., Lesko RP; Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA., El Eter L; Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA., Siotos C; Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA., McColl MA; Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA., Manahan MA; Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA., Sacks JM; Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, MO 63110, USA., Maher DP; Department of Anesthesia and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA., Rosson GD; Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA., Cooney CM; Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA. Electronic address: ccooney3@jhmi.edu.
Jazyk: angličtina
Zdroj: Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2023 Aug; Vol. 83, pp. 258-265. Date of Electronic Publication: 2023 May 13.
DOI: 10.1016/j.bjps.2023.05.007
Abstrakt: Background: Previous studies in orthopedics and general surgery have linked negative patient outcomes with preoperative opioid use. In this study, we investigated the association of preoperative opioid use on breast reconstruction outcomes and quality of life (QoL).
Methods: We reviewed our prospective registry of patients who underwent breast reconstruction for documented preoperative opioid use. Postoperative complications were recorded at 60 days after the first reconstructive surgery and 60 days after the final staged reconstruction. We used a logistic regression model to assess the association between opioid use and postoperative complications, controlling for smoking, age, laterality, BMI, comorbidities, radiation, and previous breast surgery; linear regression to analyze RAND36 scores to evaluate the impact of preoperative opioid use on postoperative QoL, controlling for the same factors; and Pearson chi-squared test to assess factors that may be associated with opioid use.
Results: Of the 354 patients eligible for inclusion, 29 (8.2%) were prescribed preoperative opioids. There were no differences in opioid use by race, BMI, comorbidities, previous breast surgery, or laterality. Preoperative opioids were associated with increased odds of postoperative complications within 60 days after the first reconstructive surgery (OR: 6.28; 95% CI: 1.69-23.4; p = 0.006) and within 60 days after the final staged reconstruction (OR: 8.38; 95% CI: 1.17-59.4; p = 0.03). Among patients using opioids preoperatively, the RAND36 physical and mental scores decreased but were not statistically significant.
Conclusion: We found that preoperative opioid use is associated with increased odds of postoperative complications among patients who underwent breast reconstruction and may contribute to clinically significant declines in postoperative QoL.
Competing Interests: Conflict of Interest Statement None.
(Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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