Postoperative Analgesia in Plastic Surgery Procedures

Abstract

Advances in the knowledge of the secondary effects of acute postoperative pain have motivated anesthesiologists and surgeons to pay special attention to its prevention and correct management. Surgical procedures in plastic surgery are very varied and produce postoperative pain in direct relation to the site, type, and extent of surgery, with facial interventions being the least painful (with the exception of rhinoplasty) and the most painful being breast surgery, abdominoplasty, and extensive liposuctions due to the possibility of trauma to peripheral nerves and greater secondary inflammation. The combination of surgeries produces more intense post-surgical pain. There is insufficient data on the frequency and severity of pain after plastic surgery, be it reconstructive or cosmetic. Although opioids have been considered to be the cornerstone in the treatment of postsurgical pain, their use in plastic surgery patients must be carefully evaluated for various reasons that interfere with the results of this type of surgery. Similar to other surgical specialties, multimodal analgesia is now the most appropriate way to prevent and treat pain in these patients. This chapter is a comprehensive review of the management of acute postoperative pain in certain plastic surgery procedures, with emphasis on the multimodal approach.