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

• Published in: Canadian journal of anesthesia 2003-04, Vol.50 (4), p.336-341
• Main Authors: FELD, James M, LAURITO, Charles E, BECKERMAN, Mihail, VINCENT, Joseph, HOFFMAN, William E
• Format: Article
• Language: English
• Subjects: Adult; Analgesia, Patient-Controlled - statistics & numerical data; Analgesics; Analgesics, Non-Narcotic - therapeutic use; Analgesics, Opioid - therapeutic use; Anesthesia; Anesthesia depending on patient's condition; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Inhalation - therapeutic use; Biological and medical sciences; Body Mass Index; Conscious Sedation; Female; Fentanyl - therapeutic use; Gastric Bypass; Gastrointestinal surgery; Hospitals; Humans; Male; Medical sciences; Methyl Ethers - therapeutic use; Morphine - therapeutic use; Neuropharmacology; Pain, Postoperative - drug therapy; Patient Satisfaction - statistics & numerical data; Pharmacology. Drug treatments; Time Factors; Weight control
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/BF03021029

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