title: Postoperative analgesia in morbid obesity.
abstract: Morbidly obese patients due to high incidence of obstructive sleep apnea (OSA) are predisposed to opioid induced airway obstruction and thus frontline high ceiling analgesics (opioids) have concerns based on safety in their liberal use. Although surgical techniques over the last two decades have seen a paradigm shift from open to laparoscopic procedures for morbidly obese patients; optimally titrated yet safe analgesic management still remains a challenge. The present review sums up the analgesic options available for management of morbidly obese patients undergoing surgery. We highlight the utility of multimodal approach for analgesia with combinations of agents to decrease opioids requirements. Pre-emptive analgesia may be additionally used to improve the efficacy of postoperative pain relief while allowing further reductions in opioid requirements.
authors.affiliation: Department of Anesthesiology, Hospital Italiano de Buenos Aires, Juan D. Peron 4190, C1181ACH, Buenos Aires, Buenos Aires Province, Argentina, tatotatun@gmail.com.
authors.forename: Adrian
authors.initials: A
authors.lastname: Alvarez
authors.forename: Preet Mohinder
authors.initials: PM
authors.lastname: Singh
authors.forename: Ashish C
authors.initials: AC
authors.lastname: Sinha
mesh_terms: D000698:Analgesia / Q000379:methods*; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy; D009407:Nerve Block / Q000379:methods*; D009767:Obesity, Morbid / Q000150:complications*; D010149:Postoperative Pain / Q000628:therapy*; D020181:Sleep Apnea, Obstructive / Q000150:complications*
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid