Management of Postoperative Pain after Bariatric Surgery


Series: Pain Management – Research and Technology
BISAC: MED093000

Patients undergoing bariatric surgery are special subjects, as they present different conditions that make it more difficult to facilitate correct postoperative management. A medical staff is often not used to managing these patients and they do not consider that different measures or doses of drugs should be employed. Moreover, several approaches performed in the general population cannot be offered to morbidly obese subjects because of their particular anatomical conditions.

The correct management of postoperative pain is essential for the adequate evolution in a postoperative course, as a patient experiencing pain will not be able to mobilize. Moreover, analgesic resources are usually morphic drugs, which might cause nausea and vomiting, impeding correct oral intake.
Multimodal analgesia is actually considered the gold standard for postoperative pain control after bariatric surgery, implying the administration of drugs or performance of different analgesic or anesthetic techniques in order to reduce the need for postoperative morphine.

For the correct application of postoperative analgesia, it is essential to know the physiopathology of postoperative pain and the mechanism of action for each analgesic technique.

Table of Contents

Table of Contents


Chapter 1. Physiopathological Basis of Postoperative Pain
(Dennis Cesar Levano-Linares, MD, Patricia Sanchez-Salcedo, Belen Manso Abajo, MD, David Alías Jimenez, MD, PhD, Manuel Durán Poveda, MD, PhD, and Jaime Ruíz-Tovar, MD, PhD, Department of Surgery, University Hospital Rey Juan Carlos, Mostoles, Madrid, Spain, and others)

Chapter 2. Intraoperative and Postoperative Analgesic Schemes in Bariatric Surgery
(Esther García Villabona, MD, Carmen Vallejo Lantero, MD, and Graciela García Villabona, MD, Anesthesiology Department, Hospital Universitario de La Princesa, Madrid, Spain, and others)

Chapter 3. Multimodal Analgesia and Adjuvant Analgesic Treatment in Bariatric Surgery
(Carmen Vallejo Lantero, MD, and Esther García Villabona, MD, Anesthesiology Department of Hospital Universitario de La Princesa, Madrid, Spain)

Chapter 4. Opioid Free Anesthesia
(Irene Portero, Department of Anesthesiology, Rey Juan Carlos Hospital, Madrid, Spain)

Chapter 5. Implications of Laparoscopic Approach on Postoperative Pain after Bariatric Surgery
(Pablo Priego, MD, PhD, Department of General Surgery, Division of Esophagogastric and Bariatric Surgery, Ramón y Cajal University Hospital, Madrid, Spain)

Chapter 6. Port Site Infiltration with Local Anesthetic Drugs
(Gilberto González Ramírez, MD, and Jaime Ruiz-Tovar, MD, PhD, Department of Bariatric Surgery Hospital Angeles del Carmen, Universidad de Guadalajara, Guadalajara, Mexico, and others)

Chapter 7. Laparoscopic-Guided Transversus Abdominis Plane (TAP) Block as Part of Multimodal Analgesia
(Jaime Ruiz-Tovar, MD, PhD, and Carolina Llavero, Department of Surgery, Universidad Autonoma de Madrid, Spain, and others)

Chapter 8. The Effect of Peritoneal Irrigation with Ropivacaine
(Montiel Jiménez-Fuertes, Department of Digestive Surgery, Rey Juan Carlos University Hospital, Móstoles (Madrid), Spain)

Chapter 9. Peritoneal Lavage and Laparoscopic Sleeve Gastrectomy Surgery
(Lorea Zubiaga, MD, PhD, and Jaime Ruiz-Tovar, MD, PhD, Surgery Department, Lille 2 University, Lille, France)

Chapter 10. Immunomodulators and Postoperative Pain: Immunonutrition and Topical Vitamin E
(Jaime Ruiz-Tovar, MD, PhD, and Carolina Llavero, Department of Surgery, Universidad Autonoma de Madrid, Spain, and others)

Keywords: Pain, Analgesia; Bariatric Surgery; Obesity; Laparoscopy

Professionals: Bariatric surgeons, Anesthesiologists, General practitioners, Nurses and Medical students.
Industry: Medical industry of laparoscopic devices (Medtronic, Johnson&Johnson), industries commercializing analgesic, anesthetic or antibiotic drugs (MSD, Bayer,…).
Non-professionals: Obesity and diabetic blogs and chats.

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