Do obese patients require less analgesia after laparoscopic cholecystectomy?

Daniela Ionescu, Anca Bălintescu, I.Belciu, I.Onicaş, H.Vasian, I.Acalovschi
Catedra ATI, Universitatea de Medicină şi Farmacie „Iuliu Haţieganu” Cluj-Napoca

Abstract

Aim. There are relatively few studies on postoperative requirements for analgesia in obese patients. Opinions in the literature are more in favor of less analgesia because of the “depot” role of the adipose tissue and the release of endogenous endorphins.

Material and methods. 39 patients ASA I/II scheduled for laparoscopic cholecystectomy were divided into 2 groups based on BMI. Group 1 (n=20) included obese patients (BMI = 30) and group 2 (n=20) included normoponderal patients. General anaesthesia was induced with fentanyl, propofol and rocuronium and maintained with isoflurane. Prior induction, all patients received 4 mg dexamethasone. Postoperative analgesia (on VAS) and pethidine requirements (administrated as 20 mg i.v. boluses at request and when VAS was =3) as well as other side effects were recorded every 6 h for the first 24 h postoperatively.

Results and conclusions. There were no differences between the two groups concerning the demographic data and the requirements for intraoperative administration of fentanyl. Postoperatively, the requirements for pethidine administration were significantly reduced in obese patients (0.370 mg/kg/24 h vs. 0.850 mg/kg/24 h) (p<0.05). Also, obese patients had significantly lower incidence of postoperative nausea and vomiting (4 vs. 10 patients).

Key words: postoperative analgesia, obese patients, laparoscopic cholecistectomy

Au obezii un necesar analgetic postoperator mai redus?

Jurnalul Român de Anestezie Terapie intensivă 2006 Vol.13 Nr.1, 36-39