Journal article
A Comparison of Multimodal Analgesic Regimens for Opioid Reduction in Elective Plastic Surgery: A Randomized Study
PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, v 11(8), e5181
Aug 2023
PMID: 37577251
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background:This trial aimed to compare the efficacy of a multimodal analgesic regimen with gabapentin to a multimodal nonsteroidal anti-inflammatory drug (NSAID) regimen following cosmetic surgery. This was a prospective randomized study of 106 patients undergoing elective outpatient cosmetic surgery. Methods:Patients were randomly assigned to a multimodal regimen of postoperative acetaminophen, gabapentin, and oxycodone with an acetaminophen and gabapentin preload or postoperative ibuprofen and oxycodone-acetaminophen protocol without a preload. Data on compliance, number of narcotic pills consumed, duration of analgesic use, pain levels, patient satisfaction, time from incision close to postanesthesia care unit (PACU) admission, and incidence of bleeding-related complications were collected and analyzed. Results:Patients from both regimens reported equivalent postoperative pain control with the exception of pain in PACU. NSAID patients exhibited a 9.3% higher rate of compliance (P = 0.01), a 6.0% higher rate of satisfaction with pain control (P = 0.04), a 25.2% shorter interval between closure and PACU (=0.01), and an 8.2% lower rate of bleeding-related complications, all of which were statistically significant (P < 0.05). Conclusions:Both regimens are viable tools in combating opioid overprescription as they both effectively reduce postoperative pain. However, the NSAID protocol resulted in greater satisfaction related to pain management and was more cost-effective by reducing emergence time from anesthesia. As there were no hematomas associated with the use of NSAIDs and a significantly higher rate of compliance, the use of NSAIDs in enhanced recovery after surgery protocols is supported.
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Details
- Title
- A Comparison of Multimodal Analgesic Regimens for Opioid Reduction in Elective Plastic Surgery: A Randomized Study
- Publication Details
- PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, v 11(8), e5181
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS; PHILADELPHIA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:001044285100003
- Scopus ID
- 2-s2.0-85168161028
- Other Identifier
- 991021861296504721
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- Web of Science research areas
- Surgery