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Fewer opioids, same comfort: ERAS comes to aesthetic surgery

Enhanced Recovery protocols let plastic surgery patients leave with far fewer opioid pills.

Pain & comfort · 2 min read

ERAS stands for Enhanced Recovery After Surgery: a bundle of habits (preparation, multimodal pain control, early movement) designed to speed recovery.

In a prospective cosmetic surgery study, the ERAS group had significantly less pain on days 0 to 3, and the authors concluded that avoiding narcotics reduced postoperative complaints without an increase in complications. The sample was small (10 ERAS vs 12 traditional), so treat it as an early signal.

A larger review of outpatient plastic surgery, with 157 patients before and 202 patients after ERAS began, found that patients were prescribed far fewer opioids: about 100 vs 332 morphine milligram equivalents per patient. Ultrasound-guided regional blocks were part of the protocol.

Why it matters: less nausea, less grogginess, and fewer leftover pills in the cupboard.

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References

  1. Bartlett EL, Zavlin D, Friedman JD, et al. Enhanced recovery after surgery: the plastic surgery paradigm shift. Aesthet Surg J. 2018;676-685. PMID 29253084
  2. Straughan DM, Lindsey JT, McCarthy M, et al. Enhanced recovery after surgery protocol with ultrasound-guided regional blocks in outpatient plastic surgery patients leads to decreased opioid prescriptions and consumption. Aesthet Surg J. 2021;NP1105-NP1114. PMID 33730152