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Peri-operative Selective Sodium Channel Blockade May Reduce Opioid Use after Breast Surgery
Sanjana Challa
*, Charlotte Thomas, Sophia Ahn, Dorien I. Schonebaum, Alynah J. Adams, Samuel J. Lin
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
Background: Suzetrigine is a novel non-opioid peripheral sodium channel inhibitor that selectively targets Nav1.8 channels and has demonstrated efficacy in postoperative pain control in Phase II and III trials. However, its effectiveness following breast surgery has not been well studied. This study evaluated the impact of perioperative Suzetrigine on postoperative opioid use in patients undergoing various breast surgeries.
Methods: A retrospective review of the TriNetX Analytics Network was conducted. Patients undergoing mastectomy, breast reconstruction, breast reduction, or breast augmentation who received Suzetrigine on the day of surgery or within one postoperative day were identified using diagnosis and procedure codes. These patients were compared to those undergoing the same procedures who did not receive Suzetrigine. One-to-one propensity score matching was performed based on age, BMI, gender, race, opioid abuse, anxiety, and affective mood disorders. Postoperative opioid consumption within 72 hours was compared using risk ratios and t-tests.
Results: A total of 161 patients who received Suzetrigine were matched to 161 control patients from an initial cohort of 489,038. Within 72 hours postoperatively, patients receiving Suzetrigine used significantly less intravenous opioid analgesia compared to controls (p < 0.0001). Use of non-opioid analgesics within one week postoperatively was similar between groups (p > 0.05). Suzetrigine use was not associated with increased risk of nausea, vomiting, or liver injury (all p > 0.05).
Conclusions:Perioperative Suzetrigine use was associated with significantly reduced intravenous opioid requirements within 72 hours following various breast surgeries without increased adverse effects. This decreased need for IV analgesics could translate to faster IV discontinuation and decreased length of hospital stay after breast procedures. These findings support Suzetrigine as a safe and effective adjunct to multimodal analgesia strategies.
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