© 2017 Ina Basha
One-third of the American adult population is considered overweight, a figure that is still on the rise. Obesity negatively impacts every organ system in the human body. When minimally invasive strategies such as life style changes fail, bariatric surgery procedures have become the other option. The purpose of this systemic analysis is to look at the outcomes of post-operative pain, post-operative nausea and vomiting (PONV), and the length of stay required in the postanesthesia care unit (PACU) in obese adults undergoing bariatric surgery using opioid-free general anesthesia compared to opioid-based general anesthesia. The studies included in this systematic analysis conclude that adequate post-operative pain management can be achieved with an opioid-free anesthetic plan or a decrease in opioid use, which in turn allows for extubation to occur in the operating room and less PONV. The length of stay in the PACU has been shown to be inconsistent. Some studies indicate no significant difference, whereas others show a slight decrease in length of stay in the PACU. However, a correlation between less postoperative complications, such as PONV incidences, and a decreased length of stay in the PACU can be seen. The studies are small and the research on the best anesthetic plan for obese patients undergoing bariatric surgery has yet to be established, but what is known is that the use of opioids adversely effects obese patients, and more so than non-obese patients. Many obese patients suffer from obstructive sleep apnea, decreased functional residual capacity and decreased lung compliance. This knowledge coupled with the understanding that this population is more sensitive to the respiratory depressant effects of opioids indicates that an opioid-free anesthetic may provide better post-operative outcomes.
Basha, Ina, "A Systematic Analysis On Opioid-Free General Anesthesia Versus Opioid-Based General Anesthesia For Bariatric Surgery" (2017). Nurse Anesthesia Capstones. 9.