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PAIN MANAGEMENT AND AESTHETIC (COSMETIC) SURGERY
New York, NY (January 15, 2003) - Ask any surgeon what single
question patients most often ask prior to undergoing a surgical
procedure, and chances are it's "How much will it hurt?"
Many aesthetic (cosmetic) surgical procedures cause little or
no postoperative pain; but a few can produce short-term acute
discomfort. Doctors want every surgery to be as painless as possible,
and pain management is now recognized as a vital part of the surgical
experience.
"Pain management is one of the most important aspects of
patient care," says plastic surgeon Laurie Casas, MD, who
chairs the Communications Commission of the American Society for
Aesthetic Plastic Surgery (ASAPS). "One very important issue
doctors face is how to take away the pain without causing negative
side-effects."
In a recent issue of Aesthetic Surgery Journal, ASAPS' peer-reviewed
clinical journal, Dr. Casas and plastic surgeon Mark Jewell, MD,
outline guidelines for addressing pain management after ambulatory
cosmetic plastic surgery. Drs. Casas and Jewell emphasize the
importance of educating patients about what to expect following
surgery and about monitoring patient comfort throughout the immediate
postoperative period.
Major advances in pain management techniques, and an evolution
in products, now provide significant relief to cosmetic surgery
patients and give surgeons a greater variety of options for patient
care:
Controlled and continuous infusion of local anesthesia to the
surgical site with the use of Pain Pumps offers pain control for
up to three days. Dr. Casas say that this protocol, in use since
2001, has been found to dramatically decrease postoperative pain
and the reliance on narcotics.
For regional pain management in procedures such as breast augmentation
and abdominoplasty, large area local anesthesia (LALA) is very
effective. This protocol has been successfully used by doctors
for over 70 years, and has been modified over time for increased
efficacy.
Cox-2 inhibitors, such as Celebrex and Vioxx, can be used before
and after surgery. Cox-2 inhibitors control systemic pain without
causing bleeding (a common side-effect of ibuprofen, aspirin and
naproxen).
Oral opioid combinations, such as acetaminophen and codeine,
for immediate postoperative pain control are still utilized. However,
these are known to have certain negative side effects.
"Sometimes the side-effects from a pain management protocol
are worse
than the pain from the surgery," says Dr. Casas. "All
doctors strive to give their patients the best outcome with the
least amount of pain possible."
In the long run most patients focus on the positive outcome of
the surgery, not any discomfort involved. Dr. Casas notes that
she regularly hears her patients tell prospective patients how
pleased they are with their decision to have surgery, that there
was not much pain, and they only regret they didn't do it sooner.
"Effective pain management contributes greatly to overall
patient satisfaction with cosmetic surgery," says Dr. Casas.
"As patient advocates, plastic surgeons see it as intrinsic
to the surgical experience."
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The American Society for Aesthetic Plastic Surgery (ASAPS)
is the leading organization of plastic surgeons certified by the
American Board of Plastic Surgery (ABPS) who specialize in cosmetic
surgery of the face and the entire body.
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