ArticleAesthetic surgery journal2025
Intrathecal Morphine vs Paravertebral Nerve Blocks for Analgesia After Breast Reconstruction With Abdominally Based Free Flaps.
Article in Aesthetic surgery journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBreast reconstruction with abdominally based free flaps can be associated with more significant acute pain and longer hospital stays than implant-based techniques. As new pain management strategies are developed, there have not been any studies conducted to analyze the analgesic effects of intrathecal morphine (ITM) for patients undergoing abdominally based free flap reconstruction.
objectivesThe primary outcome analyzed in this retrospective study was opioid consumption, which was measured from the postoperative anesthesia care unit (PACU) through postoperative day (POD) 2. Secondary outcomes of the study analyzed included factors such as pain scores, hospital length of stay (LOS), and adverse effects.
methodsFifty-one patients presented for breast reconstruction with abdominally based free flaps and received ITM for postoperative analgesia. Results obtained were compared with a cohort that included an equal number of patients who received paravertebral nerve blocks (PVBs).
resultsResults showed that patients who received ITM displayed a lower median consumption in the PACU (0 mg vs 12.5 mg MEQ; P = .009), from PACU to POD 1 (0 mg vs 7.5 mg MEQ; P = .046), and POD 1 to POD 2 (7.5 mg vs 30 mg MEQ; P = .002) when compared with those who received PVBs. Those who received ITM also had lower median pain scores in the PACU and from PACU to POD 1 and a decreased LOS. There were similar rates of adverse events.
conclusionsITM improves postoperative analgesia after abdominally based free flaps when compared to PVBs and may facilitate recovery and earlier discharge. LEVEL OF EVIDENCE: 3:
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