Obesity Surgery

, Volume 23, Issue 9, pp 1458–1475

Challenges in the Optimisation of Post-operative Pain Management with Opioids in Obese Patients: a Literature Review

  • C. Lloret-Linares
  • A. Lopes
  • X. Declèves
  • A. Serrie
  • S. Mouly
  • J.-F. Bergmann
  • S. Perrot
Review

DOI: 10.1007/s11695-013-0998-8

Cite this article as:
Lloret-Linares, C., Lopes, A., Declèves, X. et al. OBES SURG (2013) 23: 1458. doi:10.1007/s11695-013-0998-8

Abstract

An increasing number of obese patients are undergoing surgery, particularly bariatric and orthopaedic surgery. The physiological differences between obese and normal-weight subjects may modify not only anaesthetic requirements during surgery but also post-operative analgesic management, raising a number of challenges in a critical period. In this review, we analyse studies of post-operative pain management with opioids in obese subjects. We discuss the genetic factors common to pain and obesity and the factors potentially modifying opioid pharmacokinetics and pharmacodynamics in obese patients, and we analyse the overall efficacy and safety of opioids for pain management during the post-operative period in obese patients. Both modifications to surgical methods and additional analgesic treatments to decrease the requirement for opioids may improve early rehabilitation and quality of care and reduce adverse effects in obese patients.

Keywords

Morphine Obesity Post-operative pain Surgery Analgesia 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • C. Lloret-Linares
    • 1
    • 2
  • A. Lopes
    • 1
  • X. Declèves
    • 2
  • A. Serrie
    • 2
    • 3
  • S. Mouly
    • 1
    • 2
  • J.-F. Bergmann
    • 1
    • 2
  • S. Perrot
    • 4
    • 5
  1. 1.INSERM U705, CNRS UMR 8206, Neuropsychopharmacology of Drug Addiction, Faculty of PharmacyUniversity Paris DescartesParisFrance
  2. 2.Hôpital Lariboisière, Unit of Therapeutic Research, Department of Internal MedicineAssistance Publique-Hôpitaux de ParisParisFrance
  3. 3.Hôpital Lariboisière, Centre de Traitement et d’Evaluation de la DouleurAssistance Publique-Hôpitaux de ParisParisFrance
  4. 4.Hôpital Cochin-Hotel-Dieu, Centre de Traitement et d’Evaluation de la DouleurAssistance Publique-Hôpitaux de ParisParisFrance
  5. 5.INSERM: U 987, physio-pharmacologie de la douleurHôpital Ambroise ParéParisFrance