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As advancements are made in the field of genital-based gender affirmation surgery, it is important to optimize postoperative pain control and patient well-being. Abigail Tirrell @abigailrtirrellprs and her co-authors from MedStar Georgetown Department of Plastic and Reconstructive Surgery retrospectively analyzed the impact of opioid-based patient-controlled anesthesia (PCA) on postoperative pain control in the setting of enhanced recovery after surgery (ERAS) protocols after penile inversion vaginoplasty (PIV), a physically and emotionally demanding procedure for transgender patients. They found that eliminating the use of PCA as a mainstay of postoperative pain control in favor of non-patient controlled opioid use resulted in a reduction in opioid consumption by greater than 50% without impacting average pain scores. This suggests that postoperative pain after PIV can be well controlled without opioid-based PCA protocols, leading to decreased opioid use and its resulting sequelae. Abigail R Tirrell, BS @abigailrtirrellprs; Areeg A Abu El Hawa @aabuelhawaprs; Jenna C Bekeny @jbekenyprs; Kenneth L Fan @kenfanmd; Gabriel Del Corral @drdelcorralplasticsurgery

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