Transition to Nonopioid Analgesia Does Not Impair Pain Control After Major Aesthetic Plastic Surgery
| Autor: | Clayton L. Moliver, Thu-Hoai C Nguyen, Nicholas F. Lombana, Dmitry Zavlin |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.drug_class Narcotic medicine.medical_treatment Analgesic 030230 surgery Perioperative Care Pacu Young Adult 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Humans Pain Management Medicine Antiemetic Hydrocodone Acetaminophen Aged Pain Measurement Retrospective Studies Pain Postoperative Cyclooxygenase 2 Inhibitors biology business.industry General Medicine Middle Aged Plastic Surgery Procedures biology.organism_classification Analgesics Opioid Drug Combinations Regimen Treatment Outcome Opioid Celecoxib Anesthesia Anticonvulsants Drug Therapy Combination Female Surgery Gabapentin business medicine.drug |
| Zdroj: | Aesthetic Surgery Journal. 38:1139-1144 |
| ISSN: | 1527-330X 1090-820X |
| Popis: | Background:Multimodal analgesic protocols are increasingly favored over traditional opioid regimens due to decreased adverse side effects and reduced opioid consumption. Concomitant use of selective cyclooxygenase (COX)-2 inhibitor celecoxib and anticonvulsant gabapentin have been proposed to adequately control acute postoperative pain. Objectives:To determine efficacy of postoperative pain control using nonopioid pain regimen vs traditional opioids for all aesthetic plastic surgery procedures. Methods:A retrospective chart review was performed on 462 consecutive outpatient plastic surgery procedures by a single surgeon between November 2015 and July 2017. Procedures in the historical control group (n = 275) received traditional postoperative narcotic, hydrocodone-acetaminophen. Patients in the more recent nonopioid study group (n = 187) received a pre-, peri-, and postoperative regimen of celecoxib and gabapentin. Results:Similar demographic characteristics between the control and study groups were observed: mean age, 39.7 vs 39.5 years; BMI, 24.6 vs 24.4 kg/m2; and ratio of female patients 92.7% vs 92.4%. A significant reduction in rescue analgesia (meperidine 44.6% vs 14.9%, P < 0.001) and antiemetic use (ondansetron 24.2% vs 16.3%, P < 0.05; promethazine 17.0% vs 4.7%, P < 0.001) in postanesthesia recovery unit (PACU) was noted in the nonopioid group compared to the control. The average stay in PACU also decreased in the study group (82 ± 39 min vs 70 ± 22 min, P < 0.001). Both groups reported low numbers of adverse events and need for additional pain prescriptions. These findings were reproducible in the breast subgroup. Conclusions:This nonopioid regimen is as effective as traditional opioid use for acute postoperative pain control and decreased recovery time for outpatient aesthetic plastic breast surgeries. Level of Evidence 3 |
| Databáze: | OpenAIRE |
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