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Pain Management 2019 & Internal Medicine 2019
International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X
Page 59
JOINT EVENT
7
th
Edition of International Conference on
Pain Management
8
th
Edition of International Conference on
Internal Medicine &
Patient Care
&
March 25-26, 2019
Rome, Italy
Int J Anesth Pain Med 2019, Volume 5
DOI: 10.21767/2471-982X-C1-006
Bariatric surgery and pain: Are we doing the right thing?
Patti Kastanias
1, 3
, Sandra Robinson
1
and Florence Paat
2
, Wei Wang
1
, Carol
Lopez
1
and
Arlene Buzon
1
1
University Health Network - Toronto Western Hospital, Canada
2
Toronto Rehabilitation Institute, Canada
3
Lawrence Bloomberg Faculty of Nursing-
University of Toronto, Canada
E
vidence suggests obesity may be the number
one cause of death in North America. Canadian
clinical guidelines have identified bariatric surgery as
the only recommendation for sustained weight loss in
morbidly obese persons who have been unsuccessful
at losing weight. Toronto Western Hospital (TWH),
University Health Network is a large volume Center
of Excellence which performs two types of bariatric
surgeries: Roux-en-Y gastric bypass and vertical sleeve
gastrectomy. There are challenges with designing an
optimal postoperative pain management regime for
obese individuals due to altered pharmacokinetics in
obesity. Very few studies examine pain management
post bariatric surgery however pain remains one of the
top three causes of readmission after bariatric surgery.
The purpose of this longitudinal, descriptive, correlational
study was to examine acute and chronic pain and patient
satisfaction with pain management both pre and post
bariatric surgery. Fifty seven patients having bariatric
surgery at one surgical center in 2013 were followed
longitudinally and data from validated, self-report
instruments including the BPI-SF and Numerical Pain
Rating scale were collected at 7 time points. Repeated
measures ANOVA was used to compare mean acute
pain scores at rest and with mobilization. Chronic pain
scores for average, worst and least pain were compared
preoperatively and at 6 months postoperatively using a
pairedT-test. Chronic pain interference scores totalled for
each of the 2 time points: preop and 6 months postop.
The mean scores for the 2 time points were compared
using a paired T-test. Consistent with existing literature,
the preliminary results of this study demonstrate a high
level of patient satisfaction with pain management
following bariatric surgery. There was a trend towards
decreased acute, post-operative pain both at rest and
with mobilization over time. There was a significant trend
towards decreased average chronic pain severity and
pain interference scores at 6 months post operatively.
This study was limited by its small sample size which
was drawn from a single surgical center. However this
study provides preliminary evidence that acute pain
after laparoscopic bariatric surgery is reasonably well
controlled and chronic pain and pain interference may
improve after bariatric surgery.
patti.kastanias@gmail.com