Which Do You Think is Better for Pain After a Tummy Tuck?

Question

I'm on methadone and am going to have a tummy tuck. For the post op pain management, I wanted to know which would better help with the pain, tramadol or the on q pain pump for 5 days?

Larry S. Nichter, MD, MS, FACS · Answer

The short answer is the On-Q pain pump works better. The long answer is that Exparel is a better choice.Essentially Exparel is a very long-acting local anesthetic that works great. It lasts approximately 3 or more days following injection. This is the same length of time that a pain pump lasts and will therefore take the place of a pain pump. This means patients can enjoy the same effect of a pain pump, but without any catheters and no pain pump to carry around plus decreases spasm of muscles after a tummy tuck.Exparel will be available for those concerned about minimizing discomfort after surgeries such as tummy tuck and breast augmentation.Exparel costs the same as a pain pump and produces the same result but with less hassle. I use if in virtually all of my tummy tuck patients.

Vincent N. Zubowicz, MD · Answer

With a methadone history your postop pain management will be more complicated. I'm not a big fan of pain pumps but Marcaine injected into the fascia at the time of closing seems to help. Toradol is an excellent drug but can be given orally for only a brief time.

Mark D. Epstein, MD, FACS · Answer

I used the On-Q Pain pump for about 12 years or so before going to Exparel. I have been using Exparel for about 1 1/2 years now and there is no comparison. It is not uncommon for patients to require as little as only tylenol after surgery or a couple of narcotic pain pills the first day or two (and I mean a couple of pain pills!). Although the On - Q pump works, the degree of pain relief, in my opinion, as well as that of my recovery room nurses (becasue we have discussed this) is far, far better with Exparel.

Richard Baxter, MD · Answer

First, it is really best to have your pain management doctor involved. However, a good way to minimize your pain and therefore the need for medications is Exparel, a long-acting numbing agent that would be injected during surgery and lasts for up to 3 days. An On-Q works the same way except that it has an external reservoir and slowly infuses a numbing medication through small catheters.

David Shifrin, MD · Answer

Tramadol could also aid in pain control, but the pain pump is a great help in numbing the abdominal wall!

	 

	good luck

Which Do You Think is Better for Pain After a Tummy Tuck?

Answers (10)