Pain Management in Plastic Surgery

Abstract

Most patients who undergo cosmetic surgery do not report pain during the immediate postoperative period. However, most patients who underwent liposuction combined with or without other plastic surgical procedure suffer pain after surgery. There are three main techniques in acute pain management postoperatively which are systemic analgesia, regional analgesia, and local/topical analgesia, and these are the extent of trauma during the procedure, surgeon's skill, prior disease, location and type of incision, and psychological and cultural factors. Treatment for each type of plastic surgery and the resulting pain require techniques that can be used as single method or combined with each other to relieve postoperative pain after plastic surgery. Nausea, vomiting, constipation, somnolence, etc., are well-known adverse effects of opioids. Although these effects may seem minor, they can lead to significant complications following some type of plastic surgeries, for example, face-lift hematoma following nausea and vomiting, pulmonary complications from respiratory depression, and even thromboembolic phenomena from bed rest following prolonged opioid use. Multimodal pain management has been documented to increase patient satisfaction and reduce both opioid use and the incidence of PONV. Combination of pain management in plastic surgery included patient-controlled analgesia intravenous (PCA-IV), patient-controlled epidural analgesia (PCEA), patientcontrolled regional analgesia (PCRA), field block (TAP block), continuous wound infusion system using pain pump and tumescent analgesia with local anesthetics.

Postoperative Analgesia in Plastic Surgery Procedures

“…The pharmacological management of POP in plastic surgery plays a fundamental aspect since it reduces complications, long stays, and costs, and favors rapid recovery after surgery. Various drugs and locoregional analgesia, including the tumescent technique widely used in plastic surgery, are part of multimodal analgesia programs in these patients [6,[22][23][24].…”