Efficacy of Enhanced Recovery After Surgery Pathway for Total Mastectomy

Study Overview
=================
Brief Summary
-----------------
Retrospective analysis of pre and post-Enhanced Recovery after Surgery for Total mastectomy pathway implementation.

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.

Official Title
-----------------
Efficacy of Enhanced Recovery After Surgery Pathway for Total Mastectomy

Conditions
-----------------
Mastectomy, Breast Cancer Female

Intervention / Treatment
-----------------
* Other: ERAS pathway for Total Mastectomy


Participation Criteria
=================
Eligibility Criteria
-----------------
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

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| pre-ERAS<br>Patients cared for prior to the implementation of the Enhanced Recovery after surgery for total mastectomy pathway | |
| post-ERAS<br>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. | Other: ERAS pathway for Total Mastectomy<br>* Enhanced Recovery after Surgery (ERAS) pathway for Total Mastectomy<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| perioperative opioid consumption | perioperative opioid consumption | through study completion (average of 1 year) | 

Secondary Outcome Measures

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

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Enhanced Recovery after Surgery (ERAS), Fast-track surgery, Pec Blocks, Mastectomy