Acute postoperative pain and opioid consumption after laparoscopic cholecystectomy is associated with body mass index: a retrospective observational single-center study

Abstract

Aim: The aim of this study was to determine the relationship between postoperative pain scores and opioid analgesic consumption according to BMI levels in patients undergoing laparoscopic cholecystectomy.
 Material and Method: In this retrospective observational study, we scanned the medical data of 154 patients aged from 18-55 years who underwent laparoscopic cholecystectomy. Patients were divided into two groups based on the BMI cut-off value (Group Non-obese, BMI 30 kg/m2, n=35). Postoperative visual analog scale (VAS) pain scores, total tramadol consumption, and intraoperative fentanyl bolus requirements were compared between the groups at five-time points (T0: in the recovery room, T1: 1st hour in the ward, T2: 6th hour, T3: 12th hour, and T4: 24th hour).
 Results: Postoperative VAS pain scores were significantly higher in the Group Obese at T1-2 time points (p=0.009). The number of patients with a VAS score of >3 at the T-0 time point was significantly higher in the Group Obese (p=0.014). Total tramadol consumption was significantly higher in the Group Obese (40.0±46.6 mg) than in the Group Non-obese (16.10±34.0 mg) (p=0.003). There was a weak positive correlation between BMI and postoperative pain scores (T0, T-1, T-2) of the patients, and a moderate positive correlation (r=0.307) between total tramadol consumption.
 Conclusions: According to the results of this study, BMI is associated with acute postoperative pain in patients undergoing cholecystectomy, and obese patients require more opioid analgesia postoperatively. However, postoperative analgesia requirements should be determined according to BMI levels in patients undergoing cholecystectomy.