Assessment of Opioid-Prescribing Practices in Breast Augmentation: Future Directions for Prescribing Guidelines. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Crystal, Dustin T.; Cuccolo, Nicholas G.; Plewinski, Michael J.; Ibrahim, Ahmed M.S.; Sinkin, Jeremy C.; Lin, Samuel J.; Agag, Richard L.; Lee, Bernard T.
• Is Part Of: Annals of plastic surgery. Volume 86:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: opioid -- narcotic -- prescribing -- pain management; Surgery, Plastic -- Periodicals; 617.95205
• DOI: 10.1097/SAP.0000000000002430
• Languages: English
• ISSNs: 0148-7043

Abstract

Abstract : Background: The United States (US) is in the mid of an opioid epidemic propagated, in part, by prescription opioids. With excess overprescribing documented in a variety of surgical procedures, several societies have recommended opioid-prescribing guidelines. Considering the scope and postoperative pain associated with aesthetic plastic surgery procedures, earnest evaluation into opioid-prescribing practices for breast augmentation was conducted. Methods: Members of the American Society for Aesthetic Plastic Surgery were electronically surveyed on their opioid-prescribing patterns. The survey was distributed to 1709 plastic surgeons. Descriptive statistics were collated into percentages, deviations, and morphine milligram equivalents (MMEs), when appropriate. Results: Two hundred twenty-nine American Society for Aesthetic Plastic Surgery members (13.4%) provided responses. A total of 91.2% of respondents prescribe opioids to patients undergoing breast augmentation. The most commonly prescribed agents included oxycodone/acetaminophen (Percocet, 47.0%) and hydrocodone/acetaminophen (Vicodin, 38.3%). On average, 165.3 ± 81.7 MMEs were dispensed (range, 25.0–600.0 MMEs; number tablets, 5–60). Prescribers felt that a lack of phone-in prescribing (52.4%) and the ease of preemptively prescribing opioids (52.4%) propagate opioid overprescribing. A total of 61.3% of respondents reported that they are or may be in favor of developing plastic surgery societal guidelines related to opioid prescribing. These respondents indicated support for guidelines on opioid-sparing pain management strategies (74.2%) and guidelines identifying the type (54.7%), duration of use (69.5%), and number of opioid tablets (61.7%) necessary for procedures. Conclusions: Considerable variability exists among prescribing patterns after breast augmentation. Societal guidelines aimed at providers and patients may serve a future role in opioid prescribing.