Efficacy of Enhanced Recovery After Surgery Pathway for Total Mastectomy

Overview

Retrospective analysis of pre and post-Enhanced Recovery after Surgery for Total mastectomy pathway implementation.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Retrospective
  • Study Primary Completion Date: April 30, 2016

Detailed Description

Retrospective analysis of pre- and post-Enhanced Recovery after surgery for total mastectomy pathway implementation in patients at Mount Zion Hospital. We examined perioperative opioid consumption, pain scores, post-operative nausea and vomiting, benzodiazepine use, length of stay for the time period before and after implementation of an Enhanced Recovery after Surgery pathway for Total mastectomy. Pathway features included preoperative acetaminophen and gabapentin, minimizing opioids, postoperative NSAIDs, Pecs blocks, and aggressive postoperative nausea and vomiting prophylaxis.

Interventions

  • Other: ERAS pathway for Total Mastectomy
    • Enhanced Recovery after Surgery (ERAS) pathway for Total Mastectomy

Arms, Groups and Cohorts

  • pre-ERAS
    • Patients cared for prior to the implementation of the Enhanced Recovery after surgery for total mastectomy pathway
  • post-ERAS
    • patients cared for after the implementation of the Enhanced Recovery after surgery for total mastectomy pathway. Pathway included preoperative acetaminophen and gabapentin, Pec blocks, multimodal analgesia postoperatively and aggressive PONV treatment.

Clinical Trial Outcome Measures

Primary Measures

  • perioperative opioid consumption
    • Time Frame: through study completion (average of 1 year)
    • perioperative opioid consumption

Secondary Measures

  • Post-operative nausea and vomiting (PONV)
    • Time Frame: through study completion (average of 1 year)
    • incidence post-operative nausea and vomiting
  • postoperative benzodiazepine use
    • Time Frame: through study completion (average of 1 year)
    • amount of benzodiazepines used postoperatively for treatment of muscle spasm
  • Length of stay (LOS)
    • Time Frame: through study completion (average of 1 year)
    • Length of stay
  • Pain score
    • Time Frame: through study completion (average of 1 year)
    • highest pain score perioperatively
  • Surgery duration
    • Time Frame: through study completion (average of 1 year)
    • length of surgery (min)

Participating in This Clinical Trial

Inclusion Criteria

  • female patients at least 18 years old undergoing total skin sparing mastectomy at University of California San Francisco Mount Zion hospital Exclusion Criteria:

  • patients undergoing concurrent bilateral salpingo-oophorectomy, flap reconstruction

Gender Eligibility: Female

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Monica Harbell
  • Collaborator
    • Mount Zion Health Fund
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Monica Harbell, Assistant Professor – University of California, San Francisco

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