October 24, 2018

Multimodal pain control minimizes need for postop opioids after outpatient mastectomy

By: Judy Mathias

Editor's Note

Mastectomy patients treated with a new long-acting pain medication were able to be discharged the same day of surgery with a reduced need for opioids in this study presented October 23 at the American College of Surgeons 2018 Clinical Congress in Boston.

A total of 100 mastectomy patients were treated with a multimodal pain regimen, which consists of an injection of liposomal bupivacaine into the neurovascular bundle of the rib space at four to five different levels, combined with an intraoperative dose of IV ketorolac, and a single dose of IV acetaminophen. Patients go home with a prescription for a few days of acetaminophen/codeine rather than acetaminophen/oxycodone, which is a much stronger opioid.

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Of the 100 patients, only five returned to the emergency room within 30 days, and only three returned because of inadequate pain control.

The researchers are further investigating potential preoperative options that may add to their pain management regimen.


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