Table 1.

Pain Protocol

Preoperative (night before procedure)
1. Gabapentin 100 mg × 1 (for patients with history of chronic pain)
Immediate induction
1. Tylenol (Johnson & Johnson, New Brunswick, NJ) IV
Intraoperative
1. 0.5% Marcaine (30 mL) (Pfizer Inc., New York, NY) in normal saline (240 mL) and 1% lidocaine (30 mL) with epinephrine (1 amp)
2. Liposomal Bupivacaine (20 mL) diluted in normal saline (280 mL) tap block
3. Tumescent solution 1% lidocaine (20 mL) and epinephrine (1 amp) per 1 L of normal saline—average of 3 L injected per patient
Immediate postoperative (PACU before discharge)
1. Percocet 5 mg tablet (mild pain) (Endo Pharmaceuticals Inc., Malvern, PA) vs Demerol 25 mg injection (moderate pain) (Pfizer Inc., New York, NY)
Postoperative
1. Percocet 5 mg tablet PRN
2. Ativan (Pfizer Inc., New York, NY) PRN
3. Cyclobenzaprine PRN
4. Celebrex 100 mg BID ×7 d (for patients with history of chronic pain) (Pfizer Inc., New York, NY)

BID, twice a day; PACU, postanesthesia recovery unit; PRN, as needed.