Abstract:
BACKGROUND:The misuse and abuse of opioids, including overprescription, has led to the current opioid epidemic and national crisis. There is a national effort to eliminate the unnecessary prescription of opioids for analgesia. METHODS:Seventy patients were randomized to receive postoperative analgesia with either 5 mg hydrocodone with 325 mg acetaminophen (opioid control group) or 400 mg of ibuprofen [nonsteroidal antiinflammatory drug (NSAID) experimental group]. Pain levels were assessed on postoperative days 1, 2, and 7. Outcome measures included numeric pain rating scores and assessments of frequency and amount of analgesic used. RESULTS:There was no significant difference in gender (p = 0.81) or age (p = 0.61) between groups. On postoperative day 0, the NSAID group (mean ± SD, 2.54 ± 1.57) was found to be noninferior to the opioid group (mean ± SD, 3.14 ± 1.75; p = 0.003). On postoperative day 1, the NSAID group showed a lower mean pain score (mean ± SD, 1.84 ± 1.29) than the opioid group (mean ± SD, 2.46 ± 1.90; p = 0.01). However, on postoperative day 7, the difference in pain scores between the NSAID (mean ± SD, 3.29 ± 2.14) and opioid (mean ± SD, 3.14 ± 2.12; p = 0.17) groups lost statistical significance. There was no significant difference in mean day of medication cessation between the NSAID (mean ± SD, 4.73 ± 1.57) and opioid (mean ± SD, 4.28 ± 2.23; p = 0.26) groups. Seventy-six percent of patients who were prescribed opioids took fewer than eight tablets. Five patients escalated from NSAIDs to opioids. There were no adverse effects related to NSAID use. CONCLUSIONS:NSAIDs are an acceptable and safe alternative to opioids for postoperative analgesia in rhinoplasty and potentially lead to better overall pain control in some patients. Significantly reducing or eliminating opioid prescriptions may be considered in light of the current opioid epidemic. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, II.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Frants A,Garber D,Lafer MP,Gordon SA,Markey JD,Zhang Y,Wang B,Lee JWdoi
10.1097/PRS.0000000000007427subject
Has Abstractpub_date
2021-01-01 00:00:00pages
56-62issue
1eissn
0032-1052issn
1529-4242pii
00006534-202101000-00013journal_volume
147pub_type
杂志文章abstract:BACKGROUND:Abdominal donor-site flaps, including the transverse rectus abdominis musculocutaneous (TRAM) and deep inferior epigastric artery (DIEA) perforator flaps, are standard in autologous breast reconstruction. With significant variation in the vascular anatomy of the abdominal wall, preoperative imaging is essent...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000293874.71269.c9
更新日期:2008-01-01 00:00:00
abstract::This report deals with the question of performing mammography routinely after implant breast reconstruction. Mammography cannot be performed on the mastectomy flaps unless reconstruction is done. Successful mammography in this situation does require special techniques. The most probable location for a local recurrence...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199507000-00018
更新日期:1995-07-01 00:00:00
abstract::Utilizing the techniques of biostereometric photography and current state-of-the-art computergraphics, topographic contourgrams have been generated in a series of patients with complex craniofacial malformations. These contourgrams are considered useful in diagnosis and treatment planning and as an aid in postoperativ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198504000-00007
更新日期:1985-04-01 00:00:00
abstract:BACKGROUND:Midface reanimation in patients with chronic facial paralysis is not always possible with an ipsilateral or contralateral facial nerve innervating a free neuromuscular tissue transfer. Alternate use of nonfacial nerves is occasionally indicated but may potentially result in inadvertent motions. The goal of t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318290f644
更新日期:2013-07-01 00:00:00
abstract::Chemosurgical peel is a technique that has been used widely by plastic surgeons and dermatologists to remove fine and deep wrinkles of the skin. However, the reaction of elastic tissue to the cutaneous application of commonly used chemical peeling agents has not been defined. This study comparatively assessed the alte...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199708000-00035
更新日期:1997-08-01 00:00:00
abstract::To determine the best method for treating deep second- and third-degree burned hands in our institution, a prospective study comparing early excision and grafting with nonsurgical treatment was undertaken. The patients were randomly assigned to two groups, and the hands in the first group were excised and grafted with...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00006534-198204000-00017
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:After excess skin and fat are removed, a body-lift suture advances skin and suspends ptotic breasts, the mons pubis, and buttocks. For women, the lift includes sculpturing adiposity. While some excess fat may need removal, muscular men should receive a deliberate effort to achieve generalized tight skin clos...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000933
更新日期:2015-02-01 00:00:00
abstract::We studied 8 consecutive patients who had reduction mammaplasties to determine their psychological reactions. All 8 experienced pleasure with the operative results and the improvement or disappearance of their physical symptoms. Most described a general increase in self-esteem. In 5 of the 8 patients, however, there w...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1977-04-01 00:00:00
abstract::In an attempt to obtain objective analysis of outcome in reduction mammaplasty patients, a retrospective study was done for women having elective bilateral reduction mammaplasty. Participants were chosen from a pool of over 200 consecutive reduction mammaplasty patients at the University of Missouri-Columbia. Of those...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199609000-00013
更新日期:1996-09-01 00:00:00
abstract::The distal branching pattern of perforators is associated with thin anterolateral thigh flap failure. The purpose of this study was to investigate the feasibility of using photoacoustic tomography as a diagnostic imaging modality to identify anterolateral thigh perforators and their branching patterns in the subcutane...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004328
更新日期:2018-05-01 00:00:00
abstract::An alternative method for the repair of rhombic skin defects utilizing opposing Z-plasties has been developed and applied clinically. The design, orientation, and execution of this method share the simplicity of the Z-plasty. The technique has been employed successfully in over 100 cases during the past 5 years to res...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198305000-00014
更新日期:1983-05-01 00:00:00
abstract::If there is a strongly dominant vascular pedicle, a muscle may be suitable for transfer as a free myocutaneous flap. The minor vascular pedicle(s) may contribute significantly to the arterial blood flow to the overlying skin, however. The concept of doing a delay procedure (ligating the dominant pedicle) to increase t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197808000-00002
更新日期:1978-08-01 00:00:00
abstract::Recently, there have been many new designs in both the surface texture and chemical composition of breast implants that claim reduced constrictive capsular formation. The purpose of this study was to utilize a quantitative method to determine the firmness of capsules formed around saline-filled smooth silicone, textur...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199405000-00002
更新日期:1994-05-01 00:00:00
abstract::The basic principles of successful wound closure remain the same: careful preoperative evaluation, removal of underlying nonviable tissue, and well-vascularized soft-tissue coverage. Many complex or "hostile" back wound closures also require stabilization of the spine and a two-layered wound closure. The use of long a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200006000-00022
更新日期:2000-06-01 00:00:00
abstract::The dorsalis pedis flap has been used successfully for 20 years, both as a pedicled transfer for local foot reconstruction and as a free microvascular transfer. Proponents cite the reliable vascularity, versatility, ease of harvest, and thinness. Although significant donor-site morbidity has been recognized previously...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199810000-00031
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Patients with Apert, Crouzon, and Pfeiffer syndromes who have severe midfacial hypoplasia are treated by Le Fort III midface advancement. The purpose of this study was to examine long-term (10-year) midface skeletal stability and growth following Le Fort III midface advancement in growing children. METHODS:...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181e60502
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Displaced subcondylar fractures of the mandible are difficult to treat. Open reduction with internal fixation carries significant risks including devascularization of the condylar segment, facial nerve injury, and scarring. Closed treatment with mandibular-maxillary fixation alone accepts a misaligned fractu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000178047.97112.fa
更新日期:2005-09-15 00:00:00
abstract::A case of an axillary burn scar contracture treated with a scapular island flap is presented. We believe that this will be a useful addition to the treatment of burn scar contractures of the axilla. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198309000-00024
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Toxic epidermal necrolysis syndrome is a devastating disease, with mortality rates ranging between 20 and 60 percent. This study evaluated an alternative treatment approach using antishear wound care and compared outcomes using the severity of illness score for toxic epidermal necrolysis syndrome (SCORTEN) s...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181773d5d
更新日期:2008-07-01 00:00:00
abstract::After performing a chart review, the authors identified 120 patients who underwent breast cancer-related reconstruction. All charts were evaluated with regard to breast mound reconstruction type, nipple-areola reconstruction type, the interval between breast mound and nipple-areola reconstruction, the number of proced...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200208000-00013
更新日期:2002-08-01 00:00:00
abstract::Subcutaneous "pocketing" is proposed as a simple and convenient method to nourish a denuded, replanted end of a finger, when the amputation is between the lunule and the DIP joint. The investigation of a laboratory model is presented, and our initial clinical experience is reported. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197901000-00001
更新日期:1979-01-01 00:00:00
abstract::This study was undertaken to obtain more insight into the morphologic and functional performance of microvascular polytetrafluoroethylene (PTFE) prostheses. Therefore, both the cellular events of healing (n = 30) and the prostacyclin production (n = 18) of microvascular polytetrafluoroethylene prostheses (length 10 mm...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:The use of a porous high-density polyethylene implant for ear reconstruction is gradually gaining acceptance because it allows for a pleasing ear reconstruction in young children before they enter school. In response to this growing interest, the authors decided to write an article clarifying in detail all t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000004088
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Composite defects of the oral cavity are often the result of trauma or advanced-stage tumor extirpation. The resultant deformity frequently requires a three-dimensional reconstruction of bone and soft-tissue. The fibula free flap is the preferred method of reconstruction, with various modifications focused o...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000216
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The rat model has had limited utility for the study of long nerve gaps because of the small size of the animal. The authors sought to develop a simple, effective rat model for reconstruction of long nerve gap defects. METHODS:Fifteen rats had a sciatic nerve transection followed by reconstruction. Positive ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31829fe515
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Penile transplantation may provide improved outcomes compared with autogenous phalloplastic reconstruction. The optimal approach to vascularizing penile allografts is unknown. In penile replantation, typically only the dorsal arteries are repaired, but using the cavernosal and external pudendal arteries may ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000277
更新日期:2014-07-01 00:00:00
abstract::In 25 random patients undergoing rhytidectomy, we did unilateral subplatysmal-fascial dissections of the superficial musculoaponeurotic system (SMAS) of the face and neck--with redistribution of the tension of this system and fixation by suturing. Late evaluation of these patients by 3 observers showed no detectable d...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197712000-00002
更新日期:1977-12-01 00:00:00
abstract::Gracilis functioning free-muscle transplantation for the correction of pure facial paralysis has been a preferred method used by many reconstructive microsurgeons. However, for complex facial paralysis, the deficits include facial paralysis along with soft-tissue, mucosa, and/or skin defects. No adequate solution has ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000096092.09655.63
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Skeletal muscle denervation is a complex clinical problem that still lacks a comprehensive solution. Previous studies have suggested that prolonged periods of denervation lead to a decline in the muscle stem cell population, negatively affecting the ability of muscle to regenerate following reinnervation. Re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000005370
更新日期:2019-03-01 00:00:00
abstract::Craniofacial reconstructive procedures are frequently associated with some dissection or transposition of the temporalis muscle. During active growth, such muscle manipulations may influence craniofacial development. The purpose of this study was to determine the effects of surgical manipulation of the temporalis musc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199601000-00002
更新日期:1996-01-01 00:00:00