ASO Author Reflections: Discharge Without Opioids After Lumpectomy with Sentinel Node Biopsy Should be the Norm, Not the Exception

Excerpt

The opioid crisis has led to efforts to curb opioid over-prescription in the postoperative setting. Institutional and society guidelines on the number of opioid tablets that should be prescribed after various procedures have been developed,1,2 with 0–10 tablets recommended for lumpectomy with sentinel node biopsy (SLNB). Although some surgeons have stopped prescribing opioids after lumpectomy, a recent survey by the American Society of Breast Surgeons (ASBrS) showed that 80% still routinely prescribe opioids.2 These figures indicate that despite an increased awareness of the adverse effects of prescription opioids, there are still barriers to adopting non-opioid discharge protocols. This may be due to the paucity of literature demonstrating feasibility and outcomes of discharge without opioids after lumpectomy/SLNB. There is also concern that a switch to discharge without opioids could result in poorly controlled postoperative pain, leading to subsequent patient calls and opioid prescription after discharge. Our study was designed to examine these concerns.3 …