• Jakob Hedberg, Hanna Zacharias, Lars Janson, and Magnus Sundbom.
• Department of Surgical Sciences, Uppsala University, SE 751 85, Uppsala, Sweden.
• Obes Surg. 2016 Apr 1; 26 (4): 757-61.

BackgroundAs most bariatric procedures are performed by laparoscopy, hospital stay is exceptionally short, despite the habitus of patients and the rather extensive intra-abdominal surgery. To facilitate postoperative mobilization, most patients are given repeated single doses of morphine, a drug with several side effects. We aimed to evaluate the effect of preoperative treatment with a tablet of slow-release morphine (SRM) on postoperative analgesic consumption and length of stay (LOS) in laparoscopic gastric bypass (LGBP).MethodsThe SRM group (244 patients) was retrospectively compared to a control group (197 patients) concerning postoperative pain management and hospital stay by studying medical charts and data from Scandinavian Obesity Surgery Registry (SOReg).ResultsPatients in the SRM group needed significantly less analgesics during days 0, 1, and 2 postoperatively, morphine 10.7 vs. 13.6 mg, 10.2 vs. 13.9 mg, and 1.1 vs. 3.6 mg, respectively, p < 0.05, as well as acetaminophen, p < 0.05. According to a subgroup analysis, 20 mg of SRM was needed to obtain these effects. In addition, SRM patients had shorter hospital stay (2.3 vs. 3.5 days, p < 0.05) than the control group. No negative side effects were seen.ConclusionsPreoperatively administered slow-release morphine significantly reduced the need for postoperative analgesics and shortened hospital stay, without side effects or other complications. At our department, the studied regime is now routinely used in all bariatric surgery and we have started to use the concept in other groups of surgical patients.

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