Pain Management After Body and Breast Contouring Surgery Mon, Oct 1 4:30-5:30 p.m.

Plastic surgeons have traditionally prescribed post-operative pain medication the way their senior resident suggested they do it during training. The main strategy was to "give them enough so that they don't call you back in the middle of the night for pain medication"! As a result, most of us routinely give a lot of narcotic in and after hospital stay in an evidence free fashion, whether the patients need them or not. We are partly responsible for the opiate crisis we now face.

This panel will focus on alternative methods of post-operative pain management strategies that are not entirely opiate based. Some of us have not prescribed opiates for operations like breast reduction and abdominoplasty for many years in most patients in our practice. Patient education strategies that have enabled this outcome will be demonstrated with videos.

This panel will focus on practical tips and pearls on making the following changes happen: 1. Pre-operative pain management and education (management patient expectations), 2. Changing recovery PACU and nursing education and culture as well with regards to PO opioids when implementing ERAS and opioid free protocol. 3. Multimodal approach pre-op, intra-op, post-op 4. Opioid free anesthesia (protocol, Ketamine, lidocaine etc.) 5. Intra-operative blocks (TAP, PEC 1,2,3, intercostal, local infiltration anesthesia), for all breast and abdomen cases 6. Opioid free post-op 7. Ketamine drip and lidocaine drips 8. Alternative cocktail versus Exparel (we just finished a study comparing both, cocktail much cheaper, same pain control and LOS outcomes are for Breast reconstruction) 9. Changing culture for physician opioid prescription habits (agree that most MD's prescribe 'X' number of opioids all the time out of habit) 10. Partnering with anesthesia for optimal pain management 11. Outpatient body contouring ERAS

At the end of this activity, participants will be able to: 1. Decrease the amount of opiate medication routinely prescribed after these procedures 2. Take advantage of new strategies of patient pain education to decrease medications and complications 3. Provide the patients with better local anesthesia 4. Take advantage of Enhanced Recovery After Surgery (ERAS) Strategies 5. Prescribe alternative medications to decrease post-operative nausea and vomiting rates.

Program Subject to Change

Accreditation: The American Society of Plastic Surgeons® (ASPS) is accredited by the Accreditation Council for Continuing Education to provide continuing medical education for physicians.

Designation: The ASPS designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.