Postoperative pain management of the obese patient

Best Practice and Research: Clinical Anaesthesiology

Volumn 25, Issue 1, 2011, Pages 73-81

  Schug, Stephan A ^a,b   Raymann, Alexander ^b,c  

^a UNIVERSITY OF WESTERN AUSTRALIA   (Australia)

^b ROYAL PERTH HOSPITAL   (Australia)

^c Klinikum Hanover Nordstadt   (Germany)

Author keywords

analgesia; NSAIDs; obesity; opioids; postoperative pain; regional techniques

Indexed keywords

ANESTHETIC AGENT; BUPIVACAINE; CELECOXIB; CLONIDINE; CYCLOOXYGENASE 2 INHIBITOR; DEXMEDETOMIDINE; FENTANYL; GABAPENTIN; IBUPROFEN; KETAMINE; KETOROLAC; LOCAL ANESTHETIC AGENT; MORPHINE; NONSTEROID ANTIINFLAMMATORY AGENT; NORPETHIDINE; OPIATE; OXYGEN; PARACETAMOL; PARECOXIB; PETHIDINE; PREGABALIN; SEDATIVE AGENT;

ANALGESIA; APNEA; AROMATHERAPY; ARTERIAL PRESSURE; ARTICLE; ARTIFICIAL VENTILATION; BARIATRIC SURGERY; BED; BLOOD PRESSURE MEASUREMENT; COMORBIDITY; DEEP VEIN THROMBOSIS; DRUG BLOOD LEVEL; DRUG DOSE REDUCTION; DRUG HALF LIFE; EPIDURAL ANESTHESIA; HEART FAILURE; HUMAN; HYPERTENSION; HYPOXEMIA; INTENSIVE CARE UNIT; INTUBATION; LOW DRUG DOSE; LUNG EMBOLISM; MOBILIZATION; NEUROTOXICITY; NONHUMAN; OBESITY; OXYGEN THERAPY; PATHOPHYSIOLOGY; PATIENT MONITORING; PNEUMONIA; POSITIVE END EXPIRATORY PRESSURE; POSTOPERATIVE ANALGESIA; POSTOPERATIVE NAUSEA AND VOMITING; POSTOPERATIVE PAIN; POSTOPERATIVE PERIOD; PRIORITY JOURNAL; PULSE OXIMETRY; REGIONAL ANESTHESIA; RISK FACTOR; SCORING SYSTEM; SLEEP APNEA SYNDROME; STOMACH PERFORATION; THORAX EPIDURAL ANESTHESIA;

EID: 79952607987     PISSN: 15216896     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.bpa.2010.12.001     Document Type: Review

References (76)

1. Y. Leykin, T. Pellis, and E. Del Mestro Perioperative management of 195 consecutive bariatric patients European Journal of Anaesthesiology 25 2008 168 170
2. 2 Zentralblatt für Chirurgie 134 2009 43 49
3. E.E. Mason, K.E. Renquist, and D. Jiang Perioperative risks and safety of surgery for severe obesity The American Journal of Clinical Nutrition 55 1992 573S 576S
4. G.W. Smetana, V.A. Lawrence, and J.E. Cornell Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians Annals of Internal Medicine 144 2006 581 595 (Pubitemid 46768149)
5. W. Frey, and J. Pilcher Obstructive sleep-related breathing disorders in patients evaluated for bariatric surgery Obesity Surgery 13 2003 676 683 (Pubitemid 37352549)
6. G.W. Smetana Postoperative pulmonary complications: an update on risk assessment and reduction Cleveland Clinic Journal of Medicine 76 Suppl. 4 2009 S60 S65
7. B.S. von Ungern-Sternberg, A. Regli, and A. Reber Effect of obesity and thoracic epidural analgesia on perioperative spirometry British Journal of Anaesthesia 94 2005 121 127 (Pubitemid 40074920)
8. A. Eichenberger, S. Proietti, and S. Wicky Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem Anesthesia & Analgesia 95 2002 1788 1792 (Pubitemid 35423983)
9. A. Siriussawakul, S. Mandee, and J. Thonsontia Obesity, epidural analgesia, and subcostal incision are risk factors for postoperative desaturation Canadian Journal of Anesthesia 57 2010 415 422
10. J.A. Loadsman Preoperative screening for obstructive sleep apnoea - are we losing sleep over nothing? Anaesthesia and Intensive Care 37 2009 697 699
11. C. Sabers, D. Plevak, and D. Schroeder The diagnosis of obstructive sleep apnea as a risk factor for unanticipated admissions in outpatient surgery Anesthesia & Analgesia 96 2003 1328 1335 (Pubitemid 36512870)
12. R.M. Gupta, J. Parvizi, and A.D. Hanssen Postoperative complications in patients with obstructive sleep apnea syndrome undergoing hip or knee replacement: a case-control study Mayo Clinic Proceedings 76 2001 897 905 (Pubitemid 32825911)
13. D.W. Blake, C.Y. Yew, and G.B. Donnan Postoperative analgesia and respiratory events in patients with symptoms of obstructive sleep apnoea Anaesthesia and Intensive Care 37 2009 720 725
14. P. Liao, B. Yegneswaran, and S. Vairavanathan Postoperative complications in patients with obstructive sleep apnea: a retrospective matched cohort study Canadian Journal of Anesthesia 56 2009 819 828
15. S. Ahmad, A. Nagle, and R. McCarthy Postoperative hypoxemia in morbidly obese patients with and without obstructive sleep apnea undergoing laparoscopic bariatric surgery Anesthesia & Analgesia 107 2008 138 143
16. T.N. Weingarten, A.S. Flores, and J.A. McKenzie Obstructive sleep apnoea and perioperative complications in bariatric patients British Journal of Anaesthesia 106 1 2010 131 139
17. A.M. Ostermeier, M.F. Roizen, and M. Hautkappe Three sudden postoperative respiratory arrests associated with epidural opioids in patients with sleep apnea Anesthesia & Analgesia 85 1997 452 460 (Pubitemid 27349163)
18. D.J. Cullen Obstructive sleep apnea and postoperative analgesia - a potentially dangerous combination Journal of Clinical Anesthesia 13 2001 83 85 (Pubitemid 32377707)
19. J.B. Gross, K.L. Bachenberg, and J.L. Benumof Practice guidelines for the perioperative management of patients with obstructive sleep apnea: a report by the American Society of Anesthesiologists Task Force on perioperative management of patients with obstructive sleep apnea Anesthesiology 104 2006 1081 1093
20. B. Kabon, R. Rozum, and C. Marschalek Supplemental postoperative oxygen and tissue oxygen tension in morbidly obese patients Obesity Surgery 20 2010 885 894
21. R. Schumann, S. Jones, and B. Cooper Update on best practice recommendations for anesthetic perioperative care and pain management in weight loss surgery, 2004-2007 Obesity 17 2009 889 894
22. S. Huerta, S. DeShields, and R. Shpiner Safety and efficacy of postoperative continuous positive airway pressure to prevent pulmonary complications after Roux-en-Y gastric bypass Journal of Gastrointestinal Surgery 6 2002 354 358 (Pubitemid 40433539)
23. A. Rodgers, N. Walker, and S. Schug Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials BMJ British Medical Journal (Clinical Research Ed.) 321 2000 1493
24. H. Kehlet, and K. Holte Effect of postoperative analgesia on surgical outcome British Journal of Anaesthesia 87 2001 62 72 (Pubitemid 32631676)
25. M. Sharma, Y. Mehta, and R. Sawhney Thoracic epidural analgesia in obese patients with body mass index of more than 30 kg/m2 for off pump coronary artery bypass surgery Annals of Cardiac Anaesthesia 13 2010 28 33
26. R. Charghi, S. Backman, and N. Christou Patient controlled i.v. analgesia is an acceptable pain management strategy in morbidly obese patients undergoing gastric bypass surgery. A retrospective comparison with epidural analgesia Canadian Journal of Anesthesia 50 2003 672 678 (Pubitemid 37321972)
27. S. Lang, and J. Arraf Analgesia in bariatric patients following upper abdominal surgery Canadian Journal of Anesthesia 51 2004 276 (Pubitemid 39010959)
28. D.M. Popping, N. Elia, and E. Marret Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis Archives of Surgery 143 2008 990 999
29. E. Marret, C. Remy, and F. Bonnet Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery British Journal of Surgery 94 2007 665 673 (Pubitemid 46910057)
30. S. Batistich, A. Kendall, and S. Somers Analgesic requirements in morbidly obese patients Anaesthesia 59 2004 510 511 (Pubitemid 38578694)
31. G.P. Joshi, F. Bonnet, and R. Shah A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia Anesthesia & Analgesia 107 2008 1026 1040
32. G.I. Juhl, S.E. Norholt, and E. Tonnesen Analgesic efficacy and safety of intravenous paracetamol (acetaminophen) administered as a 2 g starting dose following third molar surgery European Journal of Pain 10 2006 371 377
33. T.S. Gorocs, M. Lambert, and T. Rinne Efficacy and tolerability of ready-to-use intravenous paracetamol solution as monotherapy or as an adjunct analgesic therapy for postoperative pain in patients undergoing elective ambulatory surgery: open, prospective study International Journal of Clinical Practice 63 2009 112 120
34. G.B. Corcoran, and B.K. Wong Obesity as a risk factor in drug-induced organ injury: increased liver and kidney damage by acetaminophen in the obese overfed rat The Journal of Pharmacology and Experimental Therapeutics 241 1987 921 927
35. S. Schenker, K.V. Speeg, and A. Perez The effects of food restriction in man on hepatic metabolism of acetaminophen Clinical Nutrition 20 2001 145 150 (Pubitemid 32427817)
36. W.H. Lee, W.G. Kramer, and G.E. Granville The effect of obesity on acetaminophen pharmacokinetics in man The Journal of Clinical Pharmacology 21 1981 284 287 (Pubitemid 11013036)
37. C. Remy, E. Marret, and F. Bonnet State of the art of paracetamol in acute pain therapy Current Opinion in Anaesthesiology 19 2006 562 565 (Pubitemid 44386062)
38. C. McDaid, E. Maund, and S. Rice Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) for the reduction of morphine-related side effects after major surgery: a systematic review Health Technology Assessment 14 17 2010 1 153 iii-iv
39. C.K. Ong, R.A. Seymour, and P. Lirk Combining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain Anesthesia & Analgesia 110 2010 1170 1179
40. P. White The changing role of non-opioid analgesic techniques in the management of postoperative pain Anesthesia & Analgesia 101 2005 S5 22
41. R. Govindarajan, B. Ghosh, and M. Sathyamoorthy Efficacy of ketorolac in lieu of narcotics in the operative management of laparoscopic surgery for morbid obesity Surgery for Obesity and Related Diseases 1 2005 530 535
42. J. Kamelgard Combined preemptive and preventive analgesia for open gastric bypass compares favorably with postoperative pain following laparoscopic access for the same surgery Obesity Surgery 16 2006 807 808
43. B. Ogunnaike, S. Jones, and D. Jones Anesthetic considerations for bariatric surgery Anesthesia & Analgesia 95 2002 1793 1805 (Pubitemid 35423984)
44. K. Sasse, J. Ganser, and M. Kozar Seven cases of gastric perforation in Roux-en-Y gastric bypass patients: what lessons can we learn? Obesity Surgery 18 2008 530 534
45. D.R. Abernethy, and D.J. Greenblatt Drug disposition in obese humans. An update Clinical Pharmacokinetics 11 1986 199 213 (Pubitemid 16079739)
46. S.A. Schug The role of COX-2 inhibitors in the treatment of postoperative pain Journal of Cardiovascular Pharmacology 47 Suppl. 1 2006 S82 S86
47. S.A. Schug, G.P. Joshi, and F. Camu Cardiovascular safety of the cyclooxygenase-2 selective inhibitors parecoxib and valdecoxib in the postoperative setting: an analysis of integrated data Anesthesia & Analgesia 108 2009 299 307
48. S. Kyzer, E. Ramadan, and M. Gersch Patient-controlled analgesia following vertical gastroplasty: a comparison with intramuscular narcotics Obesity Surgery 5 1995 18 21
49. D. Cottam, B. Fisher, and J. Atkinson A randomized trial of bupivicaine pain pumps to eliminate the need for patient controlled analgesia pumps in primary laparoscopic Roux-en-Y gastric bypass Obesity Surgery 17 2007 595 600 (Pubitemid 46945416)
50. J.S. Sprigge, D.S. East, and G.S. Fox Meperidine infusion for postoperative analgesia in grossly obese patients The Canadian Anaesthetists' Society Journal 29 1982 142 147 (Pubitemid 12187052)
51. P.A. Stone, P.E. Macintyre, and D.A. Jarvis Norpethidine toxicity and patient controlled analgesia British Journal of Anaesthesia 71 1993 738 740 (Pubitemid 23331011)
52. K.S. Latta, B. Ginsberg, and R.L. Barkin Meperidine: a critical review American Journal of Therapeutics 9 2002 53 68
53. C.S. Rand, J.M. Kuldau, and R.L. Yost Obesity and post-operative pain Journal of Psychosomatic Research 29 1985 43 48 (Pubitemid 15134375)
54. Y.K. Choi, R.E. Brolin, and B.K. Wagner Efficacy and safety of patient-controlled analgesia for morbidly obese patients following gastric bypass surgery Obesity Surgery 10 2000 154 159 (Pubitemid 30353186)
55. N.T. Nguyen, S.L. Lee, and C. Goldman Comparison of pulmonary function and postoperative pain after laparoscopic versus open gastric bypass: a randomized trial Journal of the American College of Surgeons 192 2001 469 476
56. R. Bennett, R. Batenhorst, and D.A. Graves Variation in postoperative analgesic requirements in the morbidly obese following gastric bypass surgery Pharmacotherapy 2 1982 50 53 (Pubitemid 12072900)
57. T.N. Weingarten, J. Sprung, and A. Flores Opioid requirements after laparoscopic bariatric surgery Obesity Surgery 2010 Jun 19 [Epub ahead of print]
58. D.A. Graves, R.L. Batenhorst, and R.L. Bennett Morphine requirements using patient-controlled analgesia: influence of diurnal variation and morbid obesity Clinical Pharmacy 2 1983 49 53 (Pubitemid 13181545)
59. J. Hudcova, E. McNicol, and C. Quah Patient controlled opioid analgesia versus conventional opioid analgesia for postoperative pain Cochrane Database Systematic Reviews 2006 CD003348
60. P.E. Macintyre Intravenous patient-controlled analgesia: one size does not fit all Anesthesiology Clinics of North America 23 2005 109 123
61. T. Ebert, H. Shankar, and R. Haake Perioperative considerations for patients with morbid obesity Anesthesiology Clinics 24 2006 621 636 (Pubitemid 44430136)
62. L. Sollazzi, C. Modesti, and F. Vitale Preinductive use of clonidine and ketamine improves recovery and reduces postoperative pain after bariatric surgery Surgery for Obesity and Related Diseases 5 2009 67 71
63. E. Visser, and S.A. Schug The role of ketamine in pain management Biomedicine & Pharmacotherapy 60 2006 341 348
64. H.S. Bakhamees, Y.M. El-Halafawy, and H.M. El-Kerdawy Effects of dexmedetomidine in morbidly obese patients undergoing laparoscopic gastric bypass Middle East Journal of Anesthesiology 19 2007 537 551
65. E.M. Tiippana, K. Hamunen, and V.K. Kontinen Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety Anesthesia & Analgesia 104 2007 1545 1556 (Pubitemid 46791300)
66. M.C. Cabrera Schulmeyer, J. de la Maza, and C. Ovalle Analgesic effects of a single preoperative dose of pregabalin after laparoscopic sleeve gastrectomy Obesity Surgery 20 12 2009 1678 1681
67. J. Kim, C. Ren, and G. Fielding Treatment with lavender aromatherapy in the post-anesthesia care unit reduces opioid requirements of morbidly obese patients undergoing laparoscopic adjustable gastric banding Obesity Surgery 17 2007 920 925 (Pubitemid 350042920)
68. H. Vila Jr., R.A. Smith, and M.J. Augustyniak The efficacy and safety of pain management before and after implementation of hospital-wide pain management standards: is patient safety compromised by treatment based solely on numerical pain ratings? Anesthesia & Analgesia 101 2005 474 480 (Pubitemid 41045233)
69. F.J. Overdyk, R. Carter, and R.R. Maddox Continuous oximetry/capnometry monitoring reveals frequent desaturation and bradypnea during patient-controlled analgesia Anesthesia & Analgesia 105 2007 412 418 (Pubitemid 47196421)
70. S. Gallagher, K. Haines, and L. Osterlund Postoperative hypoxemia: common, undetected, and unsuspected after bariatric surgery The Journal of Surgical Research 159 2010 622 626
71. B.T. Grover, D.M. Priem, and M.A. Mathiason Intensive care unit stay not required for patients with obstructive sleep apnea after laparoscopic Roux-en-Y gastric bypass Surgery of Obesity and Related Disease 6 2010 165 170
72. H. Hager, G. Mandadi, and D. Pulley A comparison of noninvasive blood pressure measurement on the wrist with invasive arterial blood pressure monitoring in patients undergoing bariatric surgery Obesity Surgery 19 2009 717 724
73. R.A. Marley, B. Hoyle, and C. Ries Perianesthesia respiratory care of the bariatric patient Journal of PeriAnesthesia Nursing 20 2005 404 431 (Pubitemid 43011396)
74. M.S. Heffline Preventing vascular complications after gastric bypass Journal of Vascular Nursing 24 2006 50 54 (Pubitemid 43776584)
75. P. Pelosi, and C. Gregoretti Perioperative management of obese patients Best Practice & Research Clinical Anaesthesiology 24 2010 211 225
76. E.H. Hulzebos, P.J. Helders, and N.J. Favie Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial JAMA The Journal of the American Medical Association 296 2006 1851 1857 (Pubitemid 44583999)