Enhanced Recovery Strategies in Elective Breast Surgery
Status:
Recruiting
Trial end date:
2022-04-01
Target enrollment:
Participant gender:
Summary
Postoperative pain, nausea, and vomiting are frustrating sequelae of elective breast surgery.
Poorly managed postoperative pain can lead to increased opioid use, increased postoperative
nausea and vomiting (PONV), delayed return to work and usual activities, unplanned hospital
admissions, surgical complications, and patient dissatisfaction. In light of the growing
opioid epidemic in the United States, any intervention that potentially minimizes opioid use
may have meaningful individual and societal impact. In patients undergoing breast reduction
and breast augmentation surgery, multiple techniques for managing postoperative pain are used
commonly. One such technique is the use of a paravertebral block (PVB), which is a method of
injecting local anesthesia into the area surrounding the spinal nerves in order to decrease
sensation and pain in the chests and breasts in the setting of breast surgery. PVB is
generally used concomitantly with standard multimodal perioperative pain management including
cool compress, non-steroidal anti-inflammatories (NSAIDs), acetaminophen, and opioids. All of
these pain management strategies are used at the University of Wisconsin and are considered
standard of care for breast surgery nationwide.
The overall purpose of this study is to evaluate interventions that aim to optimize pain
control, minimize the risk of PONV, and improve recovery after elective breast surgery. We
will do this by (1) Comparing PVB with standard pain management strategies in patients
undergoing planned breast reduction and breast augmentation, and (2) Comparing "enhanced
recovery after surgery" (ERAS) strategies to standard of care for patients undergoing planned
breast reduction and breast augmentation. This will be studied using pain assessments,
validated surveys, medication logs, and review of medical records.