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Effect of Suzetrigine on Pain Medication Use after Free Flap Surgery
Alan T. Makhoul
*1, Alexandra E. Makhoul
2, Said Azoury
11Plastic Surgery, University of Pennsylvania, Philadelphia, PA; 2Anesthesiology, University of Pennsylvania, Philadelphia, PA
Background: Suzetrigine (Journavx®) is a non-opioid oral pain medication that received FDA-approval in January 2025 to treat acute pain in adults. The outcomes of using suzetrigine to manage post-operative pain after free flap surgery have not been assessed.
Methods: The TriNetX U.S. Collaborative Network, a de-identified database containing records from 67 U.S. healthcare organizations, was queried using CPT codes to identify patients who underwent free flap surgery between January 2025 and April 2026 with and without perioperative suzetrigine use. Propensity score matching (1:1, nearest-neighbor) was performed to create two balanced cohorts controlling for age, sex, race, BMI, and history of smoking, type II diabetes, radiation, and anxiety disorder. Opioid, acetaminophen, NSAID, nausea, and constipation medication usage was compared between groups during the one-month postoperative period using t-tests.
Results: 109,738,309 records were queried, yielding 3,639 patients who underwent free flap surgery without suzetrigine use and 107 free flap patients who received suzetrigine. Post-matching, characteristics were similar between the non-suzetrigine (n = 102) and suzetrigine (n = 102) cohorts. Suzetrigine patients received fewer days of opioid medications (mean = 3.0 days, StD 2.1 vs. mean = 6.7 days, StD 6.5; p < .001), fewer days of acetaminophen (mean = 3.6 days, StD 1.9 vs. mean = 6.3, StD 6.3; p < .001), and fewer days of NSAIDs (mean = .6 days, StD 1.2 vs. mean = 1.6 days, StD 2.3; p < .001). Suzetrigine patients also required fewer days of constipation medications (mean = 2.9, StD 1.8 vs. mean = 5.3 days, StD 5.1; p < .001). No difference in nausea medication usage was observed.
Conclusion: In free flap patients, perioperative suzetrigine reduced post-operative opioid and non-opioid pain medication usage, as well as the need for constipation treatment. Suzetrigine may further reduce opioid requirements in enhanced recovery after surgery (ERAS) pathways and minimize side effects associated with analgesic treatment.
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
Back to 2026 Abstracts
Models adjusted for BMI, tissue expander size, and axillary irradiation. OR > 1 indicates higher odds with early exchange.
