Are you scared to take pain meds after surgery?

I don’t want any pain meds after surgery.

This request came from the patient at her preoperative visit. The preop visit is when I take time to go over what we are trying to accomplish with the surgery, give postoperative instructions, and give prescriptions for pain meds after surgery.

Avoiding pain meds after surgery is becoming more common.

The opioid crisis has hit us particularly hard in Ohio. And it seems to be getting worse every day.  2700 people died in Ohio from opioid overdoses in 2015. And from mid-2016 to mid-2017 there was a 39% increase in this number. With triple the US average, it’s no surprise my patients in Ohio are keen to avoid narcotics pain meds after surgery. And some patients may have a history of addiction and want to avoid narcotics for that reason.

Do you really need pain meds after surgery?

The patient I was meeting with that day was scheduled for revision of her breast implants, a procedure that would involve removing scar tissue around her current implants. This can be painful, and most of my patients do take narcotics for a few days after surgery.

But I was confident we could get her through the postop period without pain meds, especially if she was okay dealing with some discomfort. There had been a recent discussion about non-narcotic pain control regimens among a group of my Plastic surgery colleagues. The options included:

• Celebrex starting the night before. This is an NSAID like ibuprofen, but unlike ibuprofen it doesn’t cause bleeding.
• Starting gabapentin the night before surgery as well. Gabapentin, aka Neurontin,  alters the pain signals carried by your nerves.
• Using local anesthetic (lidocaine or marcaine) to numb the tissue itself.
• Taking tylenol for pain after surgery.

My patient did fantastic.

In fact, I was surprised at how well she did. But I’ve also had patients take only tylenol after breast reduction and mastopexy. And I personally took only a single pain pill after my lipo, and that was only the first night because I didn’t know what to expect.

I’ve learned over the past couple of years that my patients actually need far less pain medication after surgery than I expected. And adding non-narcotic pain medications like Celebrex and Neurontin, along with local anesthetic when possible, has decreased this need even further.

So if you’re worried about taking pain meds after surgery, there are other options. Have a question? Head over to my Facebook page and message me!

Dr. Greer is a Plastic Surgeon who practices in Cleveland, OH. Her passion is helping moms regain self-confidence by getting rid of sagginess, wrinkles, and stubborn fat. Read more about her at www.greerplastics.org.