March 2020 #PRSJournalClub Wrap-Up: Quantifying the Crisis: Opioid-Related Adverse Events in Outpatient Ambulatory Plastic Surgery

by Rami S. Kantar, MD, MPH
Surgery Resident
The University of Maryland Medical System/R. Adams Cowley Shock Trauma Center


The March 2020 edition of #PRSJournalClub provided an excellent discussion of an important article entitled “Quantifying the Crisis: Opioid-Related Adverse Events in Outpatient Ambulatory Plastic Surgery” by Dustin T. Crystal, BS; Louise L. Blankensteijn, MD; Ahmed M. S. Ibrahim, MD, PhD; Gary M. Brownstein, MD; Lawrence S. Reed, MD; David C. Watts, MD; and Samuel J. Lin, MD, MBA. This #PRSJournalClub discussion on the #PRSJournal Facebook page allowed a broad audience from around the world to ask questions and interact directly with the authors. The article can be found here.

In the study, Crystal et al. sought to evaluate and quantify opioid-related adverse events occurring in ambulatory plastic surgery. In order to do this, the authors performed a retrospective review of 43,074 cases performed between 2001 and 2008 using the American Association for Accreditation of Ambulatory Surgery Facilities quality improvement database. The authors identified 28 patients who had an opioid-related adverse event following outpatient plastic surgery procedures. Among these, 3 were fatal adverse events, while most patients who suffered non-fatal adverse events had to be admitted with and average hospital length of stay of 3.3 ± 1.7 days. This study is very timely given the current ongoing opioid crisis in the United States. The findings of this study highlight that opioid-related adverse events do occur in ambulatory plastic surgery and that alternative pain control regimens should be explored for these patients. More importantly, several of the identified adverse events may have been prevented if thorough medication prescription practices had been performed.

The article was first discussed by the current Resident Ambassadors to the PRS Editorial Board Ara Salibian, MD, Min-Jeon Chong, MD and Casey Craft, MD and the special guest moderator Brett F. Michelotti, MD. Listen to the podcast discussion here.

In a #PRSJournalClub video, Dr. Samuel J. Lin, MD, MBA, discussed this article and highlighted salient take-home points from their work. This short video can be found here.

An engaging and thought-provoking online discussion also took place on the #PRSJournal Facebook page over a two-day period (March 21-22, 2020), where all plastic surgeons and residents were able to ask questions, and get answers from the authors of the article themselves! Don’t worry if you missed it! A summary of the interesting discussion is provided below and a collection of FREE #PRSJournalClub articles that are pertinent to the topic can be found here.

We hope you enjoy the top highlights from the discussion and look forward to seeing you at the next #PRSJournalClub on Facebook!

Sincerely,
Rami

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