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Analgesic Requirements in Adolescents Undergoing Bariatric Surgery—an Observational Study

  • Janelle D. VaughnsEmail author
  • Elaine F. Williams
  • Eleanor R. Mackey
  • Jane C. Muret
  • John van den Anker
  • Evan P. Nadler
  • Zenaide M. Quezado
Original Contributions
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Abstract

Aim

To examine the impact of preexisting psychiatric/psychological diagnoses on perioperative analgesic requirements in adolescents with morbid obesity undergoing bariatric surgery.

Methods

A retrospective cohort study of adolescents with morbid obesity undergoing bariatric surgery. Primary and secondary outcomes included perioperative analgesic intake and pain scores (Numerical Rating Scale (0–10) NRS) throughout the hospital stay.

Results

From our Bariatric Surgery Research Registry, we identified 17 adolescents with psychiatric/psychological diagnoses prior to undergoing bariatric surgery. Fifteen patients from the same registry and without such diagnosis undergoing bariatric surgery during the same time interval served as controls. In both groups, there was a predominance of female patients. During the perioperative period, in both groups, oral morphine equivalent and ketorolac and acetaminophen intake were similar. Notably, the perioperative median pain scores at the times examined were below 5 for all patients. The median pain scores in the PACU, day of surgery, and first postoperative day were similar. Conversely, on postoperative day 2, pain scores were higher in patients with diagnoses of psychiatric/psychological disorders (p = 0.004) compared to those without.

Conclusion

In this cohort of morbidly obese adolescents undergoing bariatric surgery, patients with and without preexisting psychiatric/psychological diagnoses had similar analgesic requirements during the perioperative period. This finding appears contrary to those suggesting that preexisting depression and/or anxiety might be associated with increased analgesic requirements during the perioperative period.

Keywords

Anesthetics Analgesia Obesity Pediatric surgery Pain 
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Notes

Acknowledgements

We would like to acknowledge Krishna V. Manepalli, MBBS for her administrative support in the production of this manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that there are no competing interests.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Assent and Consent

Informed assent and consent was obtained from all individual participants and their parents in this study.

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Anesthesiology, Pain and Perioperative MedicineChildren’s National Health System/The George Washington University School of Medicine and Health Sciences, Washington, DC.WashingtonUSA
  2. 2.Division of Pediatric Clinical PharmacologyChildren’s National Health System/The George Washington University School of Medicine and Health Sciences, Washington, DC.WashingtonUSA
  3. 3.Division of PsychologyChildren’s National Health System/The George Washington University School of Medicine and Health Sciences, Washington, DC.WashingtonUSA
  4. 4.Departement Anesthésie Reanimation DouleurInstitut Curie PSL Research UniversityParisFrance
  5. 5.Division of Paediatric Pharmacology and PharmacometricsUniversity Children’s Hospital BaselBaselSwitzerland
  6. 6.Sheikh Zayed Institute for Pediatric Surgical InnovationChildren’s National Health System/The George Washington University School of Medicine and Health Sciences, Washington, DC.WashingtonUSA
  7. 7.Department of Perioperative MedicineNational Institutes of Health Clinical CenterBethesdaUSA

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