Cosmetic Surgery Pain Management in Atlanta, GA, and Alpharetta, GA, with Dr. Alderman
Dr. Alderman and Dr. Joiner are dedicated to enhancing your surgical experience by providing the most advanced pain management protocols available. They understand that patients are especially concerned about how their surgical pain will be addressed. Both Dr. Alderman and Dr. Joiner want you to have the best surgical experience they can deliver, which includes not only superior surgical results but also an exceptional surgical experience. Limiting your discomfort and optimizing your pain control is a high priority for both doctors.
What is ERAS?
It is multi-modal analgesia for surgical pain relief.
ERAS stands for Enhanced Recovery After Surgery. It is a pain protocol that involves several different pain medications that work synergistically to keep you comfortable. One of the goals of ERAS is to help patients avoid the need for narcotics, such as Percocet, Oxycodone, and Oxycontin. Narcotics are associated with nausea, vomiting, and constipation. Even more concerning is the potential for patients to become addicted to narcotic medication. The ERAS protocol helps patients avoid narcotics by using pain medications that work on different pain receptors. Alternating between a series of medications allows for a steadier dose of pain relief and a more comfortable post-surgery recovery.
What are some of the medications used in the ERAS protocol?
Patients are placed on a series of medications that are taken a few hours apart to allow for a more constant level of pain relief. These medications may vary depending on a patient’s allergies or medical conditions. But, in general, we use an arthritis strength Tylenol that is started a few days before surgery because it takes 24-48 hours for the medication to reach the central nervous system and work most effectively. Patients are also placed on Celebrex, which is a type of high strength anti-inflammatory but has less bleeding potential than Motrin. Gabapentin, also known as Neurontin, is also provided for optimal pain relief. Both the Celebrex and Neurontin are started the night before surgery. In addition, patients undergoing abdominoplasty or other large body contouring surgery will also have Exparel. Exparel is a long-acting local anesthetic that numbs the surrounding area where it is injected for 2-3 days. For patients with a history of motion sickness, we will also be prescribing a scopolamine patch which is applied prior to surgery and kept on for the immediate post-operative period. This patch will help minimize your potential for nausea after surgery.
How Does the ERAS Pain Protocol Impact My Anesthesia?
Dr. Joiner finds that patients on the ERAS pain protocol require fewer narcotics during surgery since the ERAS medications are started prior to the operation. The pain medications are already in your system and ready to be used before the surgery starts. Therefore, Dr. Joiner does not have to give you as much pain medication during surgery compared to a patient not on the ERAS protocol. And, as a result of needing less narcotic pain medication, patients tend to have less nausea after surgery.
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Why is it Important to Avoid Narcotic Pain Medication?
Three million U.S. citizens and 16 million people worldwide have or had an opioid use disorder. Between 1999-2019, over 500,000 deaths in the U.S. involved an opioid overdose. Dr. Alderman started using the ERAS pain protocol when it was realized that the U.S. had a major opioid epidemic. Dr. Alderman tried the ERAS pain protocol as a way to control the patient’s surgical pain but minimize the additional potential of routine pain medications such as Percocet, Oxycodone, and Vicodin. What Dr. Alderman found was that not only did patients rarely need the narcotic medication while on the ERAS pain protocol, but they also actually had better pain control, less nausea, and less constipation.
Dr. Alderman frequently has patients thank her for her concern about opioid addiction. It is not uncommon to hear that a patient’s family member suffered from addiction after just one prescription of Oxycodone or Percocet after a minor procedure such as wisdom teeth extraction. Younger patients are especially at risk for addiction to these medications. The pain protocol that Dr. Alderman has designed for her patients will optimize postoperative pain relief but will minimize any addiction potential for opioids.
Does the ERAS Pain Protocol Work? Will I Be in Pain After Surgery?
Absolutely it works! Dr. Alderman finds that her patients consistently tell her that they have minimal pain after surgery using the ERAS pain protocol. And because they need fewer narcotics after surgery, patients have less constipation and nausea. However, it is always better to hear it directly from a patient.
Please listen to this video testimonial.
Dr. Alderman’s National Leadership Roles
- Director, American Board of Plastic Surgery
- Chair, American Society of Plastic Surgery Plastic Spring Meeting
- Co-Chair, Annual Atlanta Breast Surgery Symposium
- Chairperson of the Body Contouring Section for Aesthetica, a national cosmetic surgery meeting sponsored by the American Society of Plastic Surgery
- American Society of Plastic Surgery Patient Safety Committee
- ASPS Aesthetic Surgery Advisory Committee
- Vice Chairperson, ASPS Education Aesthetic Council