Safety and Efficacy of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Used for Analgesia After Bariatric Surgery: A Retrospective Case-Control Study

  • Hicham Abou ZeidEmail author
  • Rita Kallab
  • Marie Antoinette Najm
  • Hisham Jabbour
  • Roger Noun
  • Fadi Sleilati
  • Salim Chucri
  • Christine Dagher
  • Ghassan Sleilaty
  • Nicole Naccache
Original Contributions



Non-steroidal anti-inflammatory drugs (NSAIDs) are cornerstone in multimodal analgesia protocols. This point is of great value in morbidly obese patients due to the high prevalence of restrictive pulmonary disease and obstructive sleep apnea. The aim of this study was to test the hypothesis that NSAIDs do not increase acute bariatric surgery complications while optimizing postoperative analgesia.


Databases of two medical centers were retrospectively reviewed to find all patients who underwent bariatric surgery between 1 January 2017 and 31 December 2017. Inclusion criteria were BMI greater than 30 kg/m2 and age of 16–75 years old. Patients who suffered from severe organ failure or coagulation disorders were excluded. Patient’s demographics, obesity-related diseases (diabetes, hypertension, dyslipidemia), postoperative pain scores, and morphine consumption in PACU, as well as early and late surgical complications, were collected. Patients included from the first institution (where NSAIDs analgesia was prohibited: control group) were compared to patients from the second institution (where NSAIDs analgesia was mandatory: case group).


The study population included 270 patients, 134 in the control group, and 136 in the case group. NSAIDs usage produced better analgesia with significant reduction in morphine consumption and PACU length of stay. Also, incidence of surgical complications was the same in the two groups.


NSAIDs administration do not increase postoperative complication rate after bariatric surgery. Although NSAID administration provided better analgesia and shorter PACU stay, future prospective studies are needed to confirm these encouraging results and to evaluate their impact on postoperative rehabilitation.


Bariatric surgery NSAIDs Multimodal analgesia Postoperative complications Anastomosis leak Bleeding 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

For this type of study formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Hicham Abou Zeid
    • 1
    • 2
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  • Rita Kallab
    • 1
  • Marie Antoinette Najm
    • 3
  • Hisham Jabbour
    • 1
  • Roger Noun
    • 4
  • Fadi Sleilati
    • 5
  • Salim Chucri
    • 6
  • Christine Dagher
    • 1
  • Ghassan Sleilaty
    • 7
  • Nicole Naccache
    • 1
  1. 1.Department of Anesthesia, Crtitical Care and Pain ManagementHôtel Dieu de France hospital, Saint Joseph university school of medicineBeirutLebanon
  2. 2.Hôtel Dieu de France HospitalBeirutLebanon
  3. 3.Department of AnesthesiaMonseigneur Cortbawi InstituteAdmaLebanon
  4. 4.Department of SurgeryHôtel Dieu de France hospital, Saint Joseph university school of medicineBeirutLebanon
  5. 5.Department of SurgeryMonseigneur Cortbawi InstituteAdmaLebanon
  6. 6.Department of PneumologyHôtel Dieu de France hospital, Saint Joseph university school of medicineBeirutLebanon
  7. 7.Department of StatisticsSaint Joseph university school of medicineBeirutLebanon

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