Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Dongcheng District, Beijing, 100730, P. R. China.
Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Dongcheng District, Beijing, 100730, P. R. China.
Aesthetic Plast Surg. 2023 Dec;47(6):2261-2267. doi: 10.1007/s00266-023-03504-x. Epub 2023 Jul 24.
Enhanced recovery after surgery (ERAS) has been proven to decrease the amount of opioid use and reduce postoperative pain for a variety of surgeries, including breast reconstruction. However, data on ERAS in breast augmentation is lacking.
This study aims to investigate the effectiveness and safety of ERAS for breast augmentation.
A standardized ERAS protocol was established with full consideration of all aspects of perioperative care. Patients undergoing implant-based breast augmentation were prospectively recruited between December 2020 and January 2023, and assigned to either the ERAS or non-ERAS group randomly. The primary outcome was the activity of daily living after surgery. The secondary was postoperative pain and other outcomes included time to freely elevation, vomiting frequency, the use of analgesics, and complications.
A total of 122 patients were included, with 70 in the ERAS group and 52 in the non-ERAS group. Compared to non-ERAS patients, ERAS patients had a shorter time to freely elevation of upper limbs (2.3 d vs. 5.5 d, P < 0.001). For ERAS patients, the pain scores were significantly lower on postoperative days 1 to 3, the activity of daily living index was significantly higher on postoperative days 1 to 3 and the opioids consumption was decreased (7.1 mg vs. 46.2 mg, P = 0.018). No difference was observed in complication and hospital costs between the two groups.
The ERAS protocol significantly reduced postoperative pain and the use of opioids and promoted a return to daily activities without increasing complications in breast augmentation.
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加速康复外科（ERAS）已被证明可减少多种手术（包括乳房重建术）的阿片类药物用量并减轻术后疼痛。然而，关于乳房隆乳术的 ERAS 数据尚缺乏。
本研究旨在探讨 ERAS 在乳房隆乳术中的有效性和安全性。
充分考虑围手术期护理的各个方面，制定了标准化的 ERAS 方案。2020 年 12 月至 2023 年 1 月期间，前瞻性招募接受植入物乳房隆乳术的患者，并随机分配至 ERAS 组或非 ERAS 组。主要结局为术后日常生活活动能力。次要结局为术后疼痛和其他结局，包括自由抬高上肢的时间、呕吐频率、镇痛药使用情况和并发症。
共纳入 122 例患者，其中 ERAS 组 70 例，非 ERAS 组 52 例。与非 ERAS 组患者相比，ERAS 组患者上肢自由抬高时间更短（2.3 天 vs. 5.5 天，P<0.001）。对于 ERAS 组患者，术后第 1 至 3 天的疼痛评分显著降低，术后第 1 至 3 天的日常生活活动指数显著升高，阿片类药物用量减少（7.1 毫克 vs. 46.2 毫克，P=0.018）。两组间并发症和住院费用无差异。
ERAS 方案可显著减轻乳房隆乳术后疼痛和阿片类药物使用，并促进日常生活活动的恢复，而不增加并发症。
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