Evidence map›Paper›PMID 39112773›Full record

ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2024

Postoperative pain trajectory and opioid requirements after laparoscopic bariatric surgery: a single-centre historical cohort study.

Sinead Campbell, Rachel Chin, Wai-Man Liu, Urooj Siddiqui, Patti Kastanias, Ki Jinn Chin

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Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

What it found

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Sinead CampbellDepartment of Anesthesia and Pain Management, Toronto Western Hospital, Toronto, ON, Canada.
Rachel ChinFaculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Wai-Man LiuResearch School of Finance, Actuarial Studies and Statistics, Australian National University, Canberra, ACT, Australia.
Urooj SiddiquiDepartment of Anesthesiology & Pain Medicine, University of Toronto, Toronto, ON, Canada.
Patti KastaniasBariatric Centre of Excellence, Toronto Western Hospital, Toronto, ON, Canada.
Ki Jinn ChinDepartment of Anesthesiology & Pain Medicine, University of Toronto, Toronto, ON, Canada. gasgenie@gmail.com.ORCID 0000-0002-8339-3764

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeConcerns around delayed emergence and opioid-induced ventilatory impairment in bariatric surgery can lead to intraoperative reliance on short-acting opioids and avoidance of long-acting analgesics with potential sedative effects. Nevertheless, an overly-conservative intraoperative analgesic strategy may result in significant pain at emergence and higher opioid requirements in later phases of care. We sought to establish the pattern of intraoperative analgesic use in bariatric surgical patients as well as their postoperative pain trajectory and opioid requirements.

methodsWe undertook a single-centre historical cohort study. We explored associations between intraoperative analgesic interventions and pain scores and opioid requirements in postanesthesia care units (PACUs), and associations between the quality of analgesia at emergence and subsequent pain and patient-centred recovery outcomes.

resultsWe extracted perioperative data for 939 patients who underwent bariatric metabolic surgery between January 2018 and October 2019. Only 39% of patients received long-acting opioids intraoperatively and there was minimal use of nonopioid analgesic adjuncts. Nearly 80% of patients reported moderate-to-severe pain on PACU arrival; 97% of patients received intravenous opioids for rescue analgesia (mean dose, 31 mg oral morphine equivalents). Lower pain scores at PACU admission and discharge were associated with subsequent lower inpatient pain scores, lower opioid requirements, shorter time to ambulation, and shorter length of hospital stay.

conclusionIn bariatric surgical patients, effective intraoperative analgesic strategies that improve early pain control may have an impact on recovery and pain experience. Judicious use of intraoperative opioids coupled with opioid-sparing multimodal analgesic techniques should be considered and balanced against concerns regarding opioid-related adverse effects in this patient population.

Indexed as

Analgesics, OpioidBariatric SurgeryLaparoscopyPostoperative PainAdultCohort StudiesFemaleHumansMaleMiddle AgedPain MeasurementRetrospective StudiesAnalgesics, Opioidanesthesiabariatric surgerypostoperative pain

Identifiers

PMID39112773

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.