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Non-opioid analgesia improves pain relief and decreases sedation after gastric bypass surgery

[Un traitement non opioïde améliore l’analgésie et provoque moins de sédation après un pontage gastrique]

From the Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois, USA.

Address correspondence to: Dr. William E. Hoffman, Department of Anesthesiology, M/C 515, University of Illinois at Chicago, 1740 West Taylor Street, Chicago, Illinois 60612, USA. Phone: 312-996-4018; Fax: 312-996-4019; E-mail: whoffman{at}uic.edu

Purpose: Several non-opioid drugs have been shown to provide analgesia during and after surgery. We compared sevoflurane anesthesia with fentanyl analgesia to sevoflurane and non-opioid drug treatment for gastric bypass surgery and recovery.

Methods: Thirty obese patients (body mass index > 50 kg•m^-2) undergoing gastric bypass were randomized to receive sevoflurane anesthesia with either fentanyl or a non-opioid regimen including ketorolac, clonidine, lidocaine, ketamine, magnesium sulfate, and methylprednisolone. Morphine use by patient-controlled analgesia (PCA) pump and pain score measured by visual analogue scale were determined in the postanesthesia care unit (PACU) and for the first 16 hr after surgery. Sedation was evaluated in the PACU. Investigators assessing patient outcomes were blinded to the study group.

Results: Fentanyl treated patients were more sedated in the PACU compared to the non-opioid group. Non-opioid treated patients required 5.2 ± 2.6 mg•hr^-1 morphine by PCA during their stay in the PACU while patients anesthetized with fentanyl used 7.8 ± 3.3 mg•hr^-1 (P < 0.05). Fentanyl and non-opioid treated patients showed no difference in pain score one or 16 hr after surgery.

Conclusion: Our results show that non-opioid analgesia produced pain relief and less sedation during recovery from gastric bypass surgery compared to fentanyl.

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