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This is Dr. Edward Gronka, and today we'd like to post another video, this time about pain after surgery. I've noticed on the Real Self community there are many questions about prolonged pain after surgery and how to handle pain after surgery. So that's our topic for today. So I'd like to show you a picture from surgery the other day in the operating room for a breast augmentation. As a surgeon, what we encounter, and a lot of times during the dissection you will see, if you look at that picture, that white glistening structure that goes diagonally inside the incision, that's the nerve - one of the nerves - that supplies the sensation to the breast. And, of course, the decisions are should you cut it because it's right in the field? Well that would render adhering with anesthesia, so you wouldn't have sensation to the area of skin that the nerve goes to, or do we put an implant in that pocket, which is what we normally do, and that puts a lot of stress and torsion on the nerve itself. So that can cause postoperative pain. So how do we treat postoperative pain? Well, I think most people are familiar with non-steroidal antiinflammatory drugs such as Motrin and naproxen sodium. Then there's stronger medications like oxycodone or hydrocodone, and these are our go-to medications we think which can help. But there are some other things which are available which we've found very beneficial, which we use here in our surgery center, one of which is called EXPAREL. This is a long-acting, Marcaine anesthesia that we use to inject as a solution into the area of surgery. And this basically provides a nerve block and can last up to 72 hours in duration and is very beneficial. Another, which has been around for a while, is called an On-Q Pain Pump, and this is also a Marcaine delivery system that goes through a small catheter or plastic tube that's inserted into the surgical site. It goes through the skin into the surgical site. It also lasts about 72 hours and then can easily be removed in the office when it has done its job. And then I'm sure the epidural is something that most folks are familiar with. It's used a lot during labor in childbirth. And we employ this as well, most of the time, in abdominal surgeries such as tummy tuck or abdominoplasty. And we've found that this can be very helpful, not only during the surgery, but to control pain postoperatively for a variable duration sometimes as much as a day. So these are just a brief summary of some of the pain medications and delivery systems that we have to make pain in the postoperative period more easy to tolerate.

Dr. Gronka practices at Advanced Aesthetics, 874 W. Lanier Ave Ste. 100, Fayetteville, GA 30214. (770) 461-4000


Managing Post Operative Pain