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15 - Post-operative analgesia

from Section 4 - Post-operative conditions

Published online by Cambridge University Press:  04 May 2010

Adrian Alvarez
Affiliation:
Universidad de Buenos Aires, Argentina
Jay B. Brodsky
Affiliation:
Stanford University School of Medicine, California
Hendrikus J. M. Lemmens
Affiliation:
Stanford University School of Medicine, California
John M. Morton
Affiliation:
Stanford University School of Medicine, California
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Summary

This chapter discusses different modalities for post-operative pain management in the morbidly obese (MO) patient undergoing laparoscopic and open abdominal surgery. Currently, parenteral opioids are among the most effective analgesic techniques for the relief of moderate to severe pain. Like any other surgical patient, adequate post-operative pain control for the MO is important not only for patient comfort and satisfaction, but also to reduce potential cardiopulmonary complications. By using a multimodal approach, the amount of individual analgesic drugs can be significantly reduced, while providing quality pain relief and simultaneously reducing the incidence of side effects. Patients in the non-opioid group received a combination of ketorolac, clonidine, lidocaine, ketamine, and magnesium sulfate. Pre-emptive analgesia may improve the efficacy of postoperative pain relief while allowing further reductions in opioid requirements. Obese patients with obstructive sleep apnea (OSA) appear to be much more sensitive than normal individuals to even minimal levels of s.
Type
Chapter
Information
Morbid Obesity
Peri-operative Management
Publisher: Cambridge University Press
Print publication year: 2010

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