ERAS Protocols Reduce Long-Term Opioid Use After Mastectomy

Objective: To evaluate the impact of Enhanced Recovery After Surgery (ERAS) protocols on long-term opioid use after mastectomy. Design: Retrospective single-center study. Methods: The records of patients treated with unilateral or bilateral mastectomy, with or without immediate reconstruction, were reviewed. Patients were followed up to determine long-term postoperative opioid use (>90 days and up to 365 days after surgery). An ERAS pathway for mastectomy patients was instituted in 2017. The ERAS protocol included surgeon-administered long-acting liposomal bupivacaine injections, preoperative nonopioid medications, and multimodal perioperative nausea prophylaxis. Patients were planned to be discharged home the same day. The prevalence of chronic opioid use was determined for pre-ERAS and post-ERAS cohorts. Results: 756 patients met inclusion criteria: 405 in the pre-ERAS and 351 in the post-ERAS cohorts. There were no differences between the cohorts in the types of mastectomy or use more...