Abstract
BackgroundLittle is known regarding the use of opioid analgesics among patients who have undergone bariatric surgery.The Roux-en-Y gastric bypass (RYGB) procedure has been shown to significantly increase the rate of absorption of and exposure to morphine, raising concerns regarding the potentially increased risk of side-effects and the development of substance-use disorder.ObjectivesThe aim of this study was to describe the pattern of opioid use over time following RYGB and to see if the pattern differs between patients with a high opioid consumption (HOC) prior to surgery and those with a low consumption (LOC).SettingUniversity Hospital of Örebro, Sweden.MethodsThe study was a descriptive retrospective population-based cohort study where two registers with complete coverage were cross-matched.ResultsThe study population comprised 35,612 persons (1628 HOC, and 33,984 LOC). After surgery, the number of HOC patients increased to 2218.Mean daily opioid consumption in the total population and the LOC group increased after surgery (p < .0005). In the HOC group, there was no difference between mean daily consumption before and after surgery.ConclusionIn this nationwide study, we have showed that there is an increase in consumption of opioid analgesics after gastric bypass surgery in Sweden. The increase in the number of individuals with high opioid consumption in the total population was mainly due to an increase in the group of patients with a low consumption prior to surgery.
Highlights
Morbid obesity is associated with various conditions causing musculoskeletal pain [1] often leading to use of prescription analgesics [2], including opioids
In this nationwide study, we have showed that there is an increase in consumption of opioid analgesics after gastric bypass surgery in Sweden
The aim of this retrospective cohort study, including all patients undergoing gastric bypass surgery in Sweden between May 2007 and November 2013, was to describe the pattern of opioid use over time following surgery, and to see if the pattern differs between patients with a high opioid consumption prior to surgery (HOC) and those with a low consumption (LOC)
Summary
Morbid obesity is associated with various conditions causing musculoskeletal pain [1] often leading to use of prescription analgesics [2], including opioids. The anatomical changes after Roux-en-Y gastric bypass (RYGB) can lead to changes in the pharmacokinetic properties of opioid analgesics leading to faster and more complete absorption of morphine oral solution [10], which is similar to the changes seen with ethanol [11]. This raises concerns regarding a potentially increased risk of developing substance-use disorder (SUD) [12,13,14]. The Roux-en-Y gastric bypass (RYGB) procedure has been shown to significantly increase the rate of absorption of and exposure to morphine, raising concerns regarding the potentially increased risk of side-effects and the development of substance-use disorder
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