Locoregional anesthesia in Enhanced Recovery After Surgery (ERAS) for reconstructive breast surgery: A narrative review

Abstract

This review attempts to provide a comprehensive evaluation of ERAS protocols applied to deep inferior epigastric perforator (DIEP) flap breast reconstructions. The focus is the integration of ERAS with locoregional anesthesia techniques to enhance patient outcomes, reduce opioid usage, and reduce length of stay. Employing a methodical literature review conducted through PubMed, the study synthesizes findings from articles that meet specific inclusion criteria to explore the effectiveness of ERAS in the specific context of breast reconstruction. The thesis is structured to guide the reader through the various phases of ERAS illustrating how each phase contributes to optimizing patient recovery. Special attention is given to locoregional anesthesia techniques such as transversus abdominis plane blocks and paravertebral blocks, and their role in reducing postoperative pain and opioid reliance. The discussion emphasizes the economic implications of shorter hospital stays and decreased opioid consumption, presenting ERAS not only as a clinical success but also as a cost-effective strategy. Therefore, the authors advocate for a wider adoption of ERAS protocols in reconstructive breast surgery, suggesting that further research could refine these strategies to maximize their benefits.