Beginning the morning before breast reconstruction surgery, PRMA’s Enhanced Recovery Protocol ensures a strong foundation of pain control is already in place by the time surgery begins.

During surgery, we inject long-acting local anesthetic (known as “blocks”) into each surgical site.  By doing this, pain and discomfort are very well controlled before the patient even wakes up from surgery. For our DIEP flap breast reconstruction patients, administering the “blocks” in the abdominal area has dramatically improved and minimized abdominal discomfort.

A combination of Celebrex, low-dose gabapentin, and extra-strength Tylenol are typically all our patients need to control their post-operative discomfort after leaving the hospital. Narcotics are usually only used for break-through pain during the first few post-operative days. We have found since implementing our ERAS protocol, narcotic drugs are rarely necessary beyond the initial post-operative period. Many patients report not needing any narcotics during their recovery.

PRMA’s ERAS protocol also includes a specially-formulated carbohydrate drink that patients consume before surgery. This drink enables the body to process anesthesia quicker, decreases anesthesia related nausea, speeds the return of bowel function, and optimizes healing. Patients are now able to begin eating solid food much earlier after surgery. The risk of constipation is also far less, particularly since pain control is no longer dependent on narcotics.

Combined, these new steps improve patient recovery and decrease time spent in the hospital – thanks to our Enhanced Recovery Protocol, our DIEP flap patients now usually stay only 2 days after surgery.