Op-Med is a collection of original articles contributed by Doximity members.
With Michael Howard MD
What is ERAS?
ERAS is an acronym, that’s E. R. A. S. stands for enhanced recovery after surgery it’s a broad based of best practices between surgeons, and anesthesiologists, and nursing to be able to enhance the patient’s recovery process. Now, how does that play in with opiates? Well, if you can make the patient surgical procedure better and they have less pain and discomfort well, you’ll need less narcotics.
What are your techniques to prevent pain and opioid overuse?
It starts with optimizing her medically, optimizing her pre-surgically in the holding area. It involves giving pain medications like Tylenol, Celebrex, those kinds of anti-inflammatories before surgery. It involves the surgical encounter itself. When I have the patient under anesthesia, the anesthesiologists have a lot of techniques that they can do today that allow for an enhanced surgical procedure, less anesthetic agents that need to be used. And then afterwards, using other medications for the recovery process as well.
What is your philosophy on opioids and pain management?
Opioid medications just cover up pain, so it hasn’t anything about the problem, so I say to anybody about anything when I’m dealing with plastic surgery problems. What’s the problem, what can we do about the problem? Well, the problem of pain comes from inflammation, and tightness and tissue, rearrangement. Maybe we can affect those things well before we don’t have to cover it up.