BACKGROUND:Morbid obese (MO) population is increasing every year worldwide, and laparoscopic bariatric surgery (LBS) has a central role in their treatment. The postoperative period of MO is not free from complications. The introduction of sugammadex has brought huge developments in patient's safety and nowadays LBS is performed with better care and quality. However, the effect of this agent in postoperative pain is still unknown. MATERIALS AND METHODS: A controlled trial enrolling 88 MO submitted to LBS under general anesthesia using muscle relaxation, randomly assigned into 2 groups: one received sugammadex (SUG group) at the end of surgery and the other neostigmine (NEO group). In the postanesthetic care unit (PACU), we evaluated pain using the visual analogue scale in 4 different moments: arrival in the PACU, 30 minutes after arrival, 60 minutes after arrival, and immediately before leaving the PACU. We also recorded the presence of postoperative nausea and vomits (PONV) and the duration of the PACU stay before discharge to the ward. RESULTS: Forty-four patients received sugammadex and 44 received neostigmine. We found lower visual analogue scale pain scores in the SUG group at 30 and 60 minutes after arriving to the PACU (P<0.05). We also had less PONV in the SUG group and these patients were also discharged earlier. CONCLUSIONS:Sugammadex is associated with less pain felt in the PACU. This "opioid-sparing" effect, combined with less PONV and a faster discharge from the PACU, makes sugammadex an indispensable drug in this type of patients and allows fast-track surgery in the MO.
RCT Entities:
BACKGROUND: Morbid obese (MO) population is increasing every year worldwide, and laparoscopic bariatric surgery (LBS) has a central role in their treatment. The postoperative period of MO is not free from complications. The introduction of sugammadex has brought huge developments in patient's safety and nowadays LBS is performed with better care and quality. However, the effect of this agent in postoperative pain is still unknown. MATERIALS AND METHODS: A controlled trial enrolling 88 MO submitted to LBS under general anesthesia using muscle relaxation, randomly assigned into 2 groups: one received sugammadex (SUG group) at the end of surgery and the other neostigmine (NEO group). In the postanesthetic care unit (PACU), we evaluated pain using the visual analogue scale in 4 different moments: arrival in the PACU, 30 minutes after arrival, 60 minutes after arrival, and immediately before leaving the PACU. We also recorded the presence of postoperative nausea and vomits (PONV) and the duration of the PACU stay before discharge to the ward. RESULTS: Forty-four patients received sugammadex and 44 received neostigmine. We found lower visual analogue scale pain scores in the SUG group at 30 and 60 minutes after arriving to the PACU (P<0.05). We also had less PONV in the SUG group and these patients were also discharged earlier. CONCLUSIONS:Sugammadex is associated with less pain felt in the PACU. This "opioid-sparing" effect, combined with less PONV and a faster discharge from the PACU, makes sugammadex an indispensable drug in this type of patients and allows fast-track surgery in the MO.
Authors: Bart Torensma; Chris H Martini; Martijn Boon; Erik Olofsen; Bas In 't Veld; Ronald S L Liem; Mireille T T Knook; Dingeman J Swank; Albert Dahan Journal: PLoS One Date: 2016-12-09 Impact factor: 3.240