Peri-operative Oral Pain Control Following Buccal Graft Urethroplasty

Patients undergoing buccal urethroplasty will often have significant post-operative oral pain from the graft site. Various graft harvest techniques and methods for post-harvest hemostasis including graft site closure have been explored. Despite the frequency of this clinical scenario there is no established best practice for peri-operative pain management in this patient population. In addition to traditional post operative pain control, groups have sought various peri-operative anesthetic regimens to improve post operative pain. This has led recently to the description of various regional blocks including buccal and periorbital blocks for peri-operative local anesthetic. No study has looked at superiority of regional pain management in this patient population. This study will aim to assess three established anesthetic protocols for oral pain control in a blinded, randomized controlled trial. Hypothesis: Patients who have buccal block will have lower post op pain without any increase adverse oral outcomes.

Inclusion Criteria: * Men, age 18 or older * Undergoing anterior urethroplasty with buccal grafting * Able to consent Exclusion Criteria: * Taking chronic opiates for pain * Diagnosis of chronic pain * Prior buccal urethroplasty * Vulnerable population (e.g. prisoner) * Renal dysfunction or allergy preventing NSAID use * Liver dysfunction or allergy preventing Tylenol use * Medical allergy to local anesthetic * Medical allergy to Peridex/Magic Mouthwash * NYHA Class III/IV * Hematologic condition that excludes patient from surgery * Post-operative complication resulting in inpatient stay * Anesthetic complication * No buccal site surgical complication