Opioid Coprescribing with Sedatives after Implant-Based Breast Reconstruction | Journal CME Article-Journal CME Article: Opioid Coprescribing with Sedatives after Implant-Based Breast Reconstruction Article

Journal CME Article: Opioid Coprescribing with Sedatives after Implant-Based Breast Reconstruction Article

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The study examines the prevalence and risks of coprescribing opioids with benzodiazepines and/or skeletal muscle relaxants following implant-based breast reconstruction. Annually, this procedure is prevalent among approximately 70,000 women in the United States. Despite the known risks associated with such coprescribing, including increased chances of overdose and death, these combinations are often used to manage pain and mitigate postoperative muscle contractions.<br /><br />Research uses claims data to analyze prescriptions filled by women aged 18-64 undergoing this surgery between 2008 and 2019. Results indicate that 86.7% of these women received opioid prescriptions post-surgery, with 44.5% also receiving prescriptions for benzodiazepines or muscle relaxants. Specifically, 27.7% received both opioids and benzodiazepines, and 14.4% received opioids and muscle relaxants.<br /><br />Risk factors associated with coprescribing include the use of acellular dermal matrix, immediate reconstruction, and history of anxiety. This coprescribing is linked to higher postoperative opioid refills, even after accounting for preoperative opioid exposure.<br /><br />Despite guidelines by the FDA and CDC discouraging such practices due to risks of sedation and overdose, 44.5% of patients in the study received these prescriptions. Strategies are necessary to avoid sedatives and manage pain effectively post-surgery, highlighting the need for enhanced recovery pathways that do not rely on sedatives.<br /><br />Overall, the research underscores the need for improved prescribing practices in breast reconstruction to mitigate associated risks and improve patient outcomes. The study advocates for patient education on the dangers of potential sedative use, and the need for future prospective studies to further understand and refine post-surgical pain management strategies.

Keywords

coprescribing

opioids

benzodiazepines

skeletal muscle relaxants

breast reconstruction

postoperative pain

sedation risks

prescribing practices

patient education

pain management