Multimodal analgesia model to achieve low postoperative opioid requirement following bariatric surgery

Hong Kong Med J. 2016 Oct;22(5):428-34. doi: 10.12809/hkmj154769. Epub 2016 Jul 15.

Abstract

Objective: To investigate whether a new anaesthesia protocol can reduce opioid use in obese patients following laparoscopic sleeve gastrectomy.

Methods: This prospective observational case series was conducted in a private hospital in Hong Kong that has been accredited as a Centre of Excellence for Bariatric Surgery. Thirty consecutive patients scheduled for laparoscopic sleeve gastrectomy from 1 January 2015 to 31 March 2015 were reviewed.

Results: Of the 30 patients, 14 (46.7%) did not require any opioids for rescue analgesia during the entire postoperative period; six (20.0%) required rescue opioids only in the post-anaesthetic care unit, but not in the surgical ward. The mean postoperative total opioid requirement per patient was 32 mg of pethidine.

Conclusion: With combination of multimodal analgesia with local anaesthetic infiltration, it is possible to avoid giving potent long-acting opioids in anaesthesia for bariatric surgery.

Keywords: Analgesics, opioid; Bariatric surgery.

MeSH terms

  • Adult
  • Analgesia / methods
  • Analgesics, Opioid / administration & dosage*
  • Anesthetics, Local / administration & dosage*
  • Bariatric Surgery / methods
  • Female
  • Gastrectomy / methods*
  • Hong Kong
  • Humans
  • Laparoscopy / methods
  • Male
  • Meperidine / administration & dosage
  • Middle Aged
  • Obesity / surgery
  • Pain, Postoperative / drug therapy*
  • Prospective Studies
  • Young Adult

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Meperidine