Observational studyObesity surgery2026
Impact of Preoperative Toxicological Screening on Perioperative Anesthetic Management and Short-Term Outcomes Following Metabolic and Bariatric Surgery: A Prospective Observational Study.
Observational study in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07100314 (Impact of Preoperative Toxicological Screening on Perioperative Anesthetic Management and Short-Term Outcomes Following Metabolic Bariatric Surgery), which is not on this map. Not yet cited in PubMed.
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Impact of Preoperative Toxicological Screening on Perioperative Anesthetic Management and Short-Term Outcomes Following Metabolic Bariatric Surgery: An Observational Study.
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionPreoperative substance use is increasingly observed among candidates for metabolic and bariatric surgery (MBS), yet its perioperative and 1-year effects remain unclear in the Middle East and North Africa (MENA). We assessed whether routine preoperative urine toxicology screening tests (TSTs) predict anesthetic requirements, recovery, early complications, and 1-year weight loss.
methodsProspective single-center cohort of 1,260 primary MBS patients (Alexandria, Egypt; Dec 2023–May 2024). All underwent urine screening for seven substance classes and were classified as TST-positive or TST-negative. Outcomes included propofol and intraoperative fentanyl doses, recovery metrics, postoperative pain (VAS) and opioid requirements, 30-day complications/readmissions, length of stay, and 1-year percent total and excess weight loss (%TWL, %EWL). Inverse propensity score weighting (IPSW) balanced baseline covariates. One-year outcomes were available for 1,134 of 1,260 patients (90.0%).
results190 out of 1,260 (15.1%) were TST-positive—most commonly tramadol (57.9%) and cannabis (36.8%); 12.1% denied use despite a positive TST. After IPSW adjustment, TST-positive patients required more propofol (mean difference 49.7 mg; p < 0.001) and fentanyl (MD 51.2 µg; p < 0.001), experienced longer recovery times (MD 5.36 min; p < 0.001), had higher postoperative VAS scores and opioid requirements, longer hospital stays (p < 0.001), and increased 30-day complications (5.4% vs. 1.9%; p = 0.015) and readmissions (7.1% vs. 1.6%; p < 0.001).
conclusionsRoutine preoperative TST identifies patients at risk for increased anesthetic/analgesic needs, delayed recovery, agitation, and higher early morbidity. Incorporating TST into preoperative pathways may optimize perioperative planning in MENA settings.
trial registrationNCT07100314.
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