Preoperative multimodal protocol reduced postoperative nausea and vomiting in patients undergoing mastectomy with reconstruction

Serpico, Victoria; Mone, Mary C.; Zhang, Chong; Presson, Angela P.; Killian, Heather; Agarwal, Jayant P.; Matsen, Cindy B.; Porretta, Jane; Nelson, Edward William; Junkins, Scott

doi:10.1016/j.bjps.2021.09.059

Journal of Plastic, Reconstructive & Aesthetic Surgery

2022

DOI: 10.1016/j.bjps.2021.09.059

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Preoperative multimodal protocol reduced postoperative nausea and vomiting in patients undergoing mastectomy with reconstruction

Victoria Serpico

Mary C. Mone

Chong Zhang

et al.

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Cited by 2 publications

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Evaluation of the Impact of Physical Therapy on Patients With Macromastia Seeking Breast Reduction Surgery

McCranie,

Lee,

Cyrus

et al. 2024

Aesthetic Surgery Journal

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Background Macromastia significantly impairs women's quality of life, with treatments such as physical therapy (PT) often providing only temporary relief. Insurance routinely denies breast reduction surgery, despite little relief after conservative treatments. Research on the efficacy of PT for macromastia is limited. Objectives This study investigated the efficacy of PT for macromastia and identified patient factors associated with progression to surgery. Methods We conducted a retrospective cohort study of patients with macromastia between 2017 and 2021. We collected data on presenting symptoms, attempted conservative treatments, PT duration, and whether surgery was performed. All patients were invited to participate in a survey regarding their symptoms, treatments, and responses to treatments. A multiple logistic regression was used to evaluate symptoms associated patients progressing to a breast reduction. Results Among the 327 patients identified with macromastia, 312 (95.41%) reported back pain and 272 (83.18%) attempted PT. Of the 72 (22.02%) patients who responded to the survey, 152 (46.48%) underwent subsequent surgery. The mean time from initial consultation to surgery was 283 days. Bra strap grooving was associated with progression to surgery (OR=1.90, CI=1.02-3.54). Mean patient-reported pain levels decreased after surgery compared to after PT (pre-PT=7.1, post-PT=7.1, post-surgery=3.1, P<0.001). Conclusions Patients frequently undergo PT prior to breast reduction surgery despite no significant reduction in pain, while those who undergo surgery experience permanent relief and significantly reduced pain. Patients with bra strap grooving are more likely to progress to surgery. The requirement for PT as a prerequisite for surgery by insurance companies should be reevaluated.

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Evaluation of the Impact of Physical Therapy on Patients With Macromastia Seeking Breast Reduction Surgery

McCranie,

Lee,

Cyrus

et al. 2024

Aesthetic Surgery Journal

View full text Add to dashboard Cite

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Systematized review of the literature on postoperative nausea and vomiting

David,

Merith,

Arturo

et al. 2023

JACCOA

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Introduction: Postoperative nausea and vomiting (PONV) is the most common adverse effect, after postoperative pain, with an incidence of 31.1% to 80%, which increases pain, favors broncho aspiration, wound dehiscence, and hematoma formation. Methodology: Systematized search keywords, postoperative nausea and vomiting, Incidence, therapeutics, Apfel score and risk score for postoperative nausea and vomiting, in PubMed database, the Cochrane central register of controlled trials and in http://www.clinicaltrials.gov. Results: A total of 2750 articles were obtained, and 62 articles were chosen for inclusion. Discussion: The drugs used as monotherapy to mitigate PONV such as palonosetron, fosaprepitant and aprepitant, show better results than the rest of the drugs. Conclusion: Currently, NK1 receptor antagonist drugs and 5-HT3 antagonists have been shown to have the best results in preventing PONV, however, the management of PONV should be multimodal and individualized.

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Preoperative multimodal protocol reduced postoperative nausea and vomiting in patients undergoing mastectomy with reconstruction

Cited by 2 publications

References 35 publications

Evaluation of the Impact of Physical Therapy on Patients With Macromastia Seeking Breast Reduction Surgery

Evaluation of the Impact of Physical Therapy on Patients With Macromastia Seeking Breast Reduction Surgery

Systematized review of the literature on postoperative nausea and vomiting

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