Deep anesthesia may reduce pain after sleeve gastrectomy in obese patients, suggests research

The findings of a recent clinical trial determined that obese patients who undergo laparoscopic sleeve gastrectomy experience significantly lower levels of acute postoperative pain (APP) when subjected to deeper levels of anesthesia. The findings of this study were published in the recent edition of Obesity Surgery journal offers new insights into pain management protocols that could improve the recovery outcomes.

This prospective, double-blinded randomized clinical trial included 90 patients and segregated them into two groups based on the depth of anesthesia administered during surgery. One group received what is termed as light anesthesia (Bispectral Index of 50, BIS 50), while the other was subjected to deeper anesthesia (BIS 35). Close monitoring of the pain levels was performed with the visual analogue scale (VAS) at various intervals post-surgery, specifically at 0, 12, 24, 48 and 72 hours. Along with pain levels, this study evaluated the use of analgesics, incidence of postoperative nausea and vomiting (PONV) and overall patient recovery quality through the Quality of Recovery-15 (QoR-15) score.

The results from this trial indicated that patients in the BIS 35 (deep anesthesia) group reported lower pain scores at the initial 24 hours post-operation when compared to their counterparts in the BIS 50 group. Also, these patients also expressed a reduced need for pain relief medication during their recovery period. Assessments carried out on the third day post-surgery showed elevated patient satisfaction in the group that received deeper anesthesia.

These findings suggest that the depth of anesthesia plays a pivotal role in managing APP and contributes towards reducing the consumption of analgesics and enhancing the patient satisfaction. The reduction in pain experienced by the deep anesthesia group could significantly impact recovery trajectories which potentially leads to quicker discharges from the hospital and better overall recovery experiences.

The implications of this study are majorly important for the surgical management of obesity, which is linked to increased sensitivity to pain. Thereby, optimizing anesthesia protocols during surgeries like the laparoscopic sleeve gastrectomy could become a critical element of surgical strategies. This research opens new avenues for patient care and also sets the stage for further studies and trials to explore how anesthetic depth can be leveraged to improve surgical recovery across the different types of operations.

Reference:

Zhang, X., Chen, X.-Y., Gao, R.-J., Huang, Y., Mao, S.-M., & Feng, J.-Y. (2024). The Effect of Depth of Anesthesia on Postoperative Pain in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial. In Obesity Surgery. Springer Science and Business Media LLC. https://doi.org/10.1007/s11695-024-07207-3