 No standard approach to postoperative pain control in free flap BR exists. Most protocols are institution dependent, and variably incorporate narcotics, nonsteroidal anti-inflammatory drugs NSAIDs, acetaminophen and other agents. In addition, these medications are given via oral, intramuscular, or intravenous routes. Recent studies have investigated the use of transversus abdominis plane blocks as an analgesic adjunct, and patients are often provided with patient-controlled analgesia PCA pumps in the early postoperative period. 