Skip to main content
Log in

Gender-Related Difference in Postoperative Pain After Laparoscopic Roux-En-Y Gastric Bypass in Morbidly Obese Patients

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Some evidence exist to suggest that women experience more pain and require more medication than men to achieve a similar state of analgesia. However, this was not studied in morbidly obese patients. The study evaluates the effect of gender on postoperative pain and analgesic consumption in the first 24 h in morbidly obese patients who undergo laparoscopic Roux-En-Y gastric bypass surgery (RYNGPB). One hundred thirty obese adult patients who underwent elective RYNGPB were included in the study. Postoperative pain scores were compared using a numeric rating scale, at intervals (0, 15, 30, 45, 60, 90, and 120 min), and following discharge from the postanesthesia care unit (PACU) at 6, 12, and 24 h. Titrated morphine dose during the 2-h PACU stay and pethidine consumption in the subsequent 24 h were measured. One hundred fourteen patients completed the study (59 females and 55 males). Female patients had higher initial pain scores and higher morphine consumption (10.1 ± 3.1 mg) than male patients (7.2 ± 4.5 mg), P = 0.0001. Following PACU discharge, there was no gender difference in pain scores or analgesic consumption. Pethidine consumption in male patients during the first day was 97.8 ± 35.1 versus 98.1 ± 61.6 mg among female patients, P = 0.9729. Female patients had higher initial pain score and morphine consumption than men in the immediate postoperative period, but that difference disappeared after discharge from PACU.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Cepeda MS, Carr DB. Women experience more pain and require more morphine than men to achieve a similar degree of analgesia. Anesth Analg. 2003;97(5):1464–8.

    Article  PubMed  Google Scholar 

  2. Rosseland LA, Stubhaug A. Gender is a confounding factor in pain trials: women report more pain than men after arthroscopic surgery. Pain. 2004;112(3):248–53.

    Article  PubMed  Google Scholar 

  3. Unruh AM. Gender variations in clinical pain experience. Pain. 1996;65(2–3):123–67. Review.

    Article  PubMed  CAS  Google Scholar 

  4. Kest B, Sarton E, Dahan A, et al. Gender differences in opioid mediated analgesia. Animal and human studies. Anesthesiology. 2000;93(2):539–47. Review.

    Article  PubMed  CAS  Google Scholar 

  5. Fillingim RB, King CD, Ribeiro-Dasilva MC, et al. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10(5):447–85.

    Article  PubMed  Google Scholar 

  6. Aubrun F, Salvi N, Coriat P, et al. Sex- and age-related differences in morphine requirements for postoperative pain relief. Anesthesiology. 2005;103(1):156–60.

    Article  PubMed  CAS  Google Scholar 

  7. Lemmens HJ. Perioperative pharmacology in morbid obesity. Curr Opin Anaesthesiol. 2010;23(4):485–91.

    Article  PubMed  Google Scholar 

  8. Collins JS, Lemmens HJ, Brodsky JB, et al. Laryngoscopy and morbid obesity: a comparison of the “sniff” and “ramped” positions. Obes Surg. 2004;14(9):1171–5.

    Article  PubMed  Google Scholar 

  9. Pai MP, Paloucek FP. The origin of the “ideal” body weight equations. Ann Pharmacol. 2000;34:1066–9.

    Article  CAS  Google Scholar 

  10. Banicek J, Butcher D. Acute pain management following Roux-en-Y gastric bypass surgery. Nurs Stand. 2011;25(18):35–40.

    Article  PubMed  Google Scholar 

  11. Gelb K, Gelb AW. Sex and gender in the perioperative period: wake up to reality. Anesth Analg. 2008;107(1):1–3.

    Article  PubMed  Google Scholar 

  12. Chin ML, Rosenquist R. Sex, gender, and pain: “men are from Mars, women are from Venus…”. Anesth Analg. 2008;107(1):4–5.

    Article  PubMed  Google Scholar 

  13. Coffman BL, King CD, Rios GR, et al. The glucuronidation of opioids, other xenobiotics, and androgens by human UGT2B7Y (268) and UGT2B7H (268). Drug Metab Dispos. 1998;26(1):73–7.

    PubMed  CAS  Google Scholar 

  14. Van Dorp EL, Romberg R, Sarton E, et al. Morphine-6-glucuronide: morphine's successor for postoperative pain relief? Anesth Analg. 2006;102(6):1789–97. Review.

    Article  PubMed  Google Scholar 

  15. Peckham EM, Traynor JR. Comparison of the antinociceptive response to morphine and morphine-like compounds in male and female Sprague–Dawley rats. J Pharmacol Exp Ther. 2006;316(3):1195–201.

    Article  PubMed  CAS  Google Scholar 

  16. Barsky AJ, Peekna HM, Borus JF, et al. Somatic symptom reporting in women and men. J Gen Intern Med. 2001;16:266–75.

    Article  PubMed  CAS  Google Scholar 

  17. Paulson PE, Minoshima S, Morrow TJ, et al. Gender differences in pain perception and patterns of cerebral activation during noxious heat stimulation in humans. Pain. 1998;76(1–2):223–9.

    Article  PubMed  CAS  Google Scholar 

  18. Zubieta JK, Smith YR, Bueller JA, et al. mu-Opioid receptor-mediated antinociceptive responses differ in men and women. J Neurosci. 2002;22(12):5100–7.

    PubMed  CAS  Google Scholar 

  19. Cottam DR, Fisher B, Atkinson J, et al. A randomized trial of bupivicaine pain pumps to eliminate the need for patient controlled analgesia pumps in primary laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2007;17(5):595–600.

    Article  PubMed  Google Scholar 

  20. Uchiyama K, Kawai M, Tani M, et al. Gender differences in postoperative pain after laparoscopic cholecystectomy. Surg Endosc. 2006;20(3):448–51.

    Article  PubMed  CAS  Google Scholar 

  21. De Baerdemaeker LE, Jacobs S, Pattyn P, et al. Influence of intraoperative opioid on postoperative pain and pulmonary function after laparoscopic gastric banding: remifentanil TCI vs. sufentanil TCI in morbid obesity. Br J Anaesth. 2007;99(3):404–11.

    Article  PubMed  Google Scholar 

  22. DuBois D, DuBois EF. A formula to estimate the approximate surface area if height and weight be known. Arch Int Med. 1916;17:863–71.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Tessy Sibi, CRNA, and Amira Abdul-Rahman, CRNA; Procare Riaya Hospital, Kingdom of Saudi Arabia for their skilled technical assistance.

Funding

Support was provided solely from institutional and departmental sources

Conflict of Interest

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ahed Zeidan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zeidan, A., Al-Temyatt, S., Mowafi, H. et al. Gender-Related Difference in Postoperative Pain After Laparoscopic Roux-En-Y Gastric Bypass in Morbidly Obese Patients. OBES SURG 23, 1880–1884 (2013). https://doi.org/10.1007/s11695-013-0996-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-013-0996-x

Keywords

Navigation