Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
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Surg Obes Relat Dis · Aug 2017
Review Meta AnalysisPerioperative analgesic profile of dexmedetomidine infusions in morbidly obese undergoing bariatric surgery: a meta-analysis and trial sequential analysis.
Opioid-sparing analgesia for bariatric surgery in morbidly obese can potentially prevent catastrophic airway complications. Our meta-analysis attempts to consolidate the evidence on dexmedetomidine evaluating its analgesic and safety profile. ⋯ Perioperative dexmedetomidine infusion in obese patients undergoing bariatric surgery is a promising and safe alternative. Both intraoperative or postoperative infusions lead to significant opioid sparing in early and extend postoperative recovery phase. Morbidly obese patients receiving perioperative dexmedetomidine infusions have overall better pain control and lower incidence of postoperative nausea-vomiting. All the aforementioned merits come with a stable hemodynamic profile and without any reported major adverse events.
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Surg Obes Relat Dis · Aug 2017
Multicenter Study Observational StudyAlcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study.
Empirical evidence suggests Roux-en-Y gastric bypass (RYGB) increases risk of developing alcohol use disorder (AUD). However, prospective assessment of substance use disorders (SUD) after bariatric surgery is limited. ⋯ Undergoing RYGB versus LAGB was associated with twice the risk of incident AUD symptoms. One-fifth of participants reported incident AUD symptoms within 5 years post-RYGB. AUD education, screening, evaluation, and treatment referral should be incorporated in pre- and postoperative care.
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Surg Obes Relat Dis · Aug 2017
Multicenter Study Observational StudyUse of prescribed opioids before and after bariatric surgery: prospective evidence from a U.S. multicenter cohort study.
Limited evidence suggests bariatric surgery may not reduce opioid analgesic use, despite improvements in pain. ⋯ After bariatric surgery, prevalence of prescribed opioid analgesic use initially decreased but then increased to surpass baseline prevalence, suggesting the need for alternative methods of pain management in this population.
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Surg Obes Relat Dis · Aug 2017
Cost of bariatric surgery and factors associated with increased cost: an analysis of national inpatient sample.
In the current healthcare environment, bariatric surgery centers need to be cost-effective while maintaining quality. ⋯ Factors contributing to the cost variation of bariatric procedures include co-morbidities, robotic platform, complexity of surgery, and hospital length of stay.