Obese patients can manage their pain after bariatric surgery without opioids

Obese patients can manage their pain after bariatric surgery without opioids

According to a paper from the University of Gothenburg, Sweden, obese patients undergoing bariatric surgery can do without opioids. The research paves the way for opioid-free treatment during and after surgery.

Prescribing of opioids has increased, particularly in countries like the United States, where the trend has been likened to an epidemic. Long-term use can lead to dependence and abuse. Perhaps better known as morphine, the opioid group of drugs provides short-term pain relief. However, opioids have side effects that can affect recovery from surgery. Opioids are currently the standard treatment both for treating pain impulses during surgery and for relieving patients' pain after surgical procedures, including bariatric surgery.

Researchers agree that we need to reduce the use of opioids to promote recovery after bariatric surgery. However, there is a lack of knowledge about whether alternative treatments are truly both safe and effective for the patient, particularly for treating pain following surgery.”

Alexander Olausson, anesthesiologist and doctoral student at the Sahlgrenska Academy, University of Gothenburg

Safe and effective

The work is based on a randomized clinical trial conducted at two hospitals in Sweden. In the study, 110 people undergoing bariatric surgery received either usual treatment with opioid medications or an alternative form of anesthesia and pain relief without opioids. Opioid-free treatment combines three different medications that act on pain impulses via signaling pathways other than opioids.

After surgery, opioid-free treatment was supplemented with TENS (transcutaneous electrical nerve stimulation), in which electrodes are placed on the skin and deliver weak electrical pulses to treat pain. If the alternative pain treatment was not effective enough, patients could have access to opioids.

"We see that the opioid-free treatment route is both safe and effective. The group of patients who received the opioid-free treatment required significantly fewer opioids during the treatment period and in most cases managed without opioids, while they reported no more pain than the group who received the usual opioid treatment," says Alexander Olausson.

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