Safety and Efficacy of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Used for Analgesia After Bariatric Surgery: A Retrospective Case-Control Study.
Adolescent
Adult
Aged
Analgesics
/ adverse effects
Anti-Inflammatory Agents, Non-Steroidal
/ adverse effects
Bariatric Surgery
/ adverse effects
Female
Humans
Male
Middle Aged
Morphine
/ administration & dosage
Obesity, Morbid
/ surgery
Pain, Postoperative
/ drug therapy
Prospective Studies
Retrospective Studies
Young Adult
Anastomosis leak
Bariatric surgery
Bleeding
Multimodal analgesia
NSAIDs
Postoperative complications
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
pubmed:
30
11
2018
medline:
24
3
2020
entrez:
29
11
2018
Statut:
ppublish
Résumé
Non-steroidal anti-inflammatory drugs (NSAIDs) are cornerstone in multimodal analgesia protocols. This point is of great value in morbidly obese patients due to the high prevalence of restrictive pulmonary disease and obstructive sleep apnea. The aim of this study was to test the hypothesis that NSAIDs do not increase acute bariatric surgery complications while optimizing postoperative analgesia. Databases of two medical centers were retrospectively reviewed to find all patients who underwent bariatric surgery between 1 January 2017 and 31 December 2017. Inclusion criteria were BMI greater than 30 kg/m The study population included 270 patients, 134 in the control group, and 136 in the case group. NSAIDs usage produced better analgesia with significant reduction in morphine consumption and PACU length of stay. Also, incidence of surgical complications was the same in the two groups. NSAIDs administration do not increase postoperative complication rate after bariatric surgery. Although NSAID administration provided better analgesia and shorter PACU stay, future prospective studies are needed to confirm these encouraging results and to evaluate their impact on postoperative rehabilitation.
Sections du résumé
BACKGROUND
Non-steroidal anti-inflammatory drugs (NSAIDs) are cornerstone in multimodal analgesia protocols. This point is of great value in morbidly obese patients due to the high prevalence of restrictive pulmonary disease and obstructive sleep apnea. The aim of this study was to test the hypothesis that NSAIDs do not increase acute bariatric surgery complications while optimizing postoperative analgesia.
METHODS
Databases of two medical centers were retrospectively reviewed to find all patients who underwent bariatric surgery between 1 January 2017 and 31 December 2017. Inclusion criteria were BMI greater than 30 kg/m
RESULTS
The study population included 270 patients, 134 in the control group, and 136 in the case group. NSAIDs usage produced better analgesia with significant reduction in morphine consumption and PACU length of stay. Also, incidence of surgical complications was the same in the two groups.
CONCLUSIONS
NSAIDs administration do not increase postoperative complication rate after bariatric surgery. Although NSAID administration provided better analgesia and shorter PACU stay, future prospective studies are needed to confirm these encouraging results and to evaluate their impact on postoperative rehabilitation.
Identifiants
pubmed: 30484174
doi: 10.1007/s11695-018-3608-y
pii: 10.1007/s11695-018-3608-y
doi:
Substances chimiques
Analgesics
0
Anti-Inflammatory Agents, Non-Steroidal
0
Morphine
76I7G6D29C
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
911-916Références
J Am Coll Surg. 2000 Aug;191(2):149-55; discussion 155-7
pubmed: 10945358
Gastroenterol Clin North Am. 2016 Dec;45(4):571-579
pubmed: 27837773
J Thorac Dis. 2017 Feb;9(2):386-391
pubmed: 28275487
Health Technol Assess. 2010 Mar;14(17):1-153, iii-iv
pubmed: 20346263
Proc Natl Acad Sci U S A. 1999 Jun 22;96(13):7563-8
pubmed: 10377455
BMJ. 2006 Jun 3;332(7553):1302-8
pubmed: 16740558
Br J Surg. 2012 May;99(5):721-7
pubmed: 22318712
World J Surg. 2017 Jan;41(1):200-207
pubmed: 27730354
BMC Nephrol. 2017 Aug 1;18(1):256
pubmed: 28764659
Colorectal Dis. 2013;15(10):e548-60
pubmed: 23926896
JAMA. 2004 Oct 13;292(14):1724-37
pubmed: 15479938
Sleep. 2017 Mar 01;40(3):
pubmed: 28364424
Surg Obes Relat Dis. 2008 Mar-Apr;4(2):122-5
pubmed: 18065294
Anesthesiology. 2005 Jun;102(6):1249-60
pubmed: 15915040
Surg Obes Relat Dis. 2005 Nov-Dec;1(6):530-5; discussion 535-6
pubmed: 16925285
Obes Surg. 2015 May;25(5):805-11
pubmed: 25381115
Am Surg. 1995 Dec;61(12):1079-83
pubmed: 7486451
Ann Surg. 2016 Apr;263(4):733-7
pubmed: 26106845
Ann Surg Innov Res. 2016 Mar 15;10:3
pubmed: 26981148
Pain Med. 2013 Dec;14 Suppl 1:S23-8
pubmed: 24255997
Obes Surg. 2017 May;27(5):1397
pubmed: 28271379
Dis Colon Rectum. 2013 Jan;56(1):126-34
pubmed: 23222290
Br J Surg. 2014 Oct;101(11):1413-23
pubmed: 25091299