What alternatives are there for pain management following a tummy tuck if I’m allergic to Morphine?

Question

I am highly allergic to morphine. What medication is an alternative they can use during my tummy tuck? I’m having the Exparal injection. I also have a latex allergy will they have alternatives? Morphine allergy heart rate drops drastically and they give me a epinephrine shot. Same with latex

Ashley B. Robey, MD · Answer

There certainly are alternatives to morphine and latex. Having a latex-free surgery should not be a problem; many people have latex sensitivities, and many facilities are latex-free. There are also morphine alternatives; Exparel is an effective non-narcotic alternative for pain management. Percocet, Norco and Dilaudid are pain medications that could possibly be considered by your anesthesiologist and/or plastic surgeon. Discuss your allergies with your health care providers so that a safe plan for pain management can be formulated.

Kenneth Hughes, MD · Answer

Just inform your PS and anesthesiologist of your allergies to latex and morphine. I, too, am allergic to latex so my fully accredited surgery center uses non-latex alternatives. Dilaudid or percocet can be used in lieu of morphine.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Nelson Castillo, MD · Answer

Thank you for sharing your question and best wishes on your upcoming surgery.  There are a number of different medication options that exist and trial and error may be required to find one that works for you without eliciting any negative side-effects.  Exparel will prove beneficial to you for the first few days and latex alternatives do exist for all major aspects of surgery.  Hope this helps.

Robert J. Schwartz, MD · Answer

Exparel works well to minimize your abdominal discomfort following your #abdominoplasty procedure.  Your #plasticsurgeon should review all of your allergies with you prior to your surgery and prescribe you medications that will suit you best.  I typically prescribe a non-narcotic pain management protocol because I find that patients have less sensitivities and side effects.  Latex is a non-issue these days. Every hospital and/or surgery center will have latex-free supplies to use in your case. Wishing you the very best.

Camille Cash, MD · Answer

There are several alternatives to morphine for pain management.  The Exparel should help quite a bit.  Your surgeon can prescribe a host of other pain medications to help manage your recovery.  Latex allergies are not uncommon and as long as the staff is informed of this alternative methods are available for your safety.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,You should tell your Plastic Surgeon of your issues. Every place I operate has latex free material, so this shouldn't be a problem. Relative to the pain and management: There are pain pumps, " On Q" various injections, as you mentioned, I use BKK (bupivicaine, ketamine and ketorolac), this has been great with long term control. Speak to your surgeon and your anaesthesiologist, there are protocols in place that can help you. Good luck you'll do well.Stephen M. Davis, MD, FACSCertified: American Board of Plastic SurgeryMember: American Society for Aesthetic Plastic SurgeryMember: American Society of Plastic SurgeonsMember: Realself Hall of Fame

David Janssen, MD, FACS · Answer

There is a way to have an abdominoplasty including with muscle repair without the need or use of any narcotic. the use of Exparel is wonderful but it needs to be placed accurately between the second and third layers of muscle.  In our practice I do that with ultrasound guidance at 5 different levels up and down the abdomen to make the entire abdominal wall numb for 3 days. In addition to that, the newer protocol of ERAS which is an acronym  for Enhanced Recovery After Surgery is utilized. That protocol is fairly simple.  It begins with the use of Tylenol which is actually an excellent pain medicine.  Secondarily we use Celebrex, which is a nonsteroidal anti-inflammatory agent that helps with inflammatory pain.  Finally, we use gabapentin which is a neural down regulator which blocks the pain fibers entering the spine to go up your brain.  By using those medications.  I have been able to take care of patient's and do abdominoplastys  without the use of any narcotics.  We use those also in breast augmentation patients and I been able to do breast augmentation similarly without the use of narcotic allowing people with narcotic challenges including previous addiction to have plastic surgery done.

David Finkle, MD · Answer

It is very important to notify your doctor of any medication/food/substance allergies prior to your operation.  There are many alternative medications that can be used instead and avoid the offending drugs.  Fortunately, there are many good opioid choices other than morphine.  Most surgery centers have been latex free for a long time now and avoiding latex is not a problem.Please consult with only a Board Certified Plastic Surgeon for this procedure.  Also, in your situation, ask about the surgical facility.  Is it State licensed and nationally accredited?  Is the anesthesia personnel Board Certified?  The answers to these questions need to be yes, then you can be assured if any unforeseen complication arises during your procedure, they can handle the problem.Exparel is a long acting local anesthetic that has been an absolute game changer for tummy tuck patients.  The medication lasts 3-4 days and the use of narcotic pain medication needed after the procedure is minimal.  You will be able to ambulate and move quicker and easier and the side effects of narcotic use (constipation, nausea & vomiting, lightheadedness, dizziness) will be much less.Good Luck!

Chad Robbins, MD · Answer

Hello and thank you for your question .   There is dilaudid and percocet as other options.  I would discuss with your Plastic Surgeon other alternatives.  I also give a muscle relaxer for muscle spasms.

What alternatives are there for pain management following a tummy tuck if I’m allergic to Morphine?

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