Hicham Abou Zeid1,2, Rita Kallab3, Marie Antoinette Najm4, Hisham Jabbour3, Roger Noun5, Fadi Sleilati6, Salim Chucri7, Christine Dagher3, Ghassan Sleilaty8, Nicole Naccache3. 1. Department of Anesthesia, Crtitical Care and Pain Management, Hôtel Dieu de France hospital, Saint Joseph university school of medicine, P.O.Box 11-5076, Beirut, 1107 2180, Lebanon. hicham.abouzeid@usj.edu.lb. 2. Hôtel Dieu de France Hospital, Alfred NACCACHE Blvd, Ashrafieh, P.O.Box 166830, Beirut, Lebanon. hicham.abouzeid@usj.edu.lb. 3. Department of Anesthesia, Crtitical Care and Pain Management, Hôtel Dieu de France hospital, Saint Joseph university school of medicine, P.O.Box 11-5076, Beirut, 1107 2180, Lebanon. 4. Department of Anesthesia, Monseigneur Cortbawi Institute, orange zone, road 3, Adma, 00000, Lebanon. 5. Department of Surgery, Hôtel Dieu de France hospital, Saint Joseph university school of medicine, P.O.Box 11-5076, Beirut, 1107 2180, Lebanon. 6. Department of Surgery, Monseigneur Cortbawi Institute, orange zone, road 3, Adma, 00000, Lebanon. 7. Department of Pneumology, Hôtel Dieu de France hospital, Saint Joseph university school of medicine, P.O.Box 11-5076, Beirut, 1107 2180, Lebanon. 8. Department of Statistics, Saint Joseph university school of medicine, P.O.Box 11-5076, Beirut, 1107 2180, Lebanon.
Abstract
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/m2 and age of 16-75 years old. Patients who suffered from severe organ failure or coagulation disorders were excluded. Patient's demographics, obesity-related diseases (diabetes, hypertension, dyslipidemia), postoperative pain scores, and morphine consumption in PACU, as well as early and late surgical complications, were collected. Patients included from the first institution (where NSAIDs analgesia was prohibited: control group) were compared to patients from the second institution (where NSAIDs analgesia was mandatory: case group). 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.
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are cornerstone in multimodal analgesia protocols. This point is of great value in morbidly obesepatients 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/m2 and age of 16-75 years old. Patients who suffered from severe organ failure or coagulation disorders were excluded. Patient's demographics, obesity-related diseases (diabetes, hypertension, dyslipidemia), postoperative pain scores, and morphine consumption in PACU, as well as early and late surgical complications, were collected. Patients included from the first institution (where NSAIDs analgesia was prohibited: control group) were compared to patients from the second institution (where NSAIDs analgesia was mandatory: case group). 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.
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