Department of Anesthesiology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, No. 6 Zhenhua East Road, Lianyungang, 222002, Jiangsu, China.
Obes Surg. 2024 May;34(5):1793-1800. doi: 10.1007/s11695-024-07207-3. Epub 2024 Apr 8.
Patients with obesity are more sensitive to pain and more likely to have acute postoperative pain (APP). Studies have shown that the depth of anesthesia may affect the incidence of APP. The purpose of the study was to look into the connection between APP and depth of anesthesia in patients with obesity undergoing laparoscopic sleeve gastrectomy.
This is a prospective, double-blinded randomized clinical trial, 90 patients undergoing laparoscopic sleeve gastrectomy were randomly divided into two groups: the light anesthesia group (Bispectral Index of 50, BIS 50) and the deep anesthesia group (BIS 35). The degree of pain was evaluated by the visual analogue scale (VAS) at 0, 12, 24, 48, and 72 h after surgery. The use of analgesics, grade of postoperative nausea and vomiting (PONV), and the Quality of Recovery-15 (QoR-15) score were recorded.
The VAS scores at rest or coughing at 0, 12, and 24 h after surgery in the BIS 35 group were lower than those in the BIS 50 group (P < 0.05). Fewer patients in the deep anesthesia group needed analgesia during the recovery period, and patient satisfaction was higher on the 3rd day after surgery (P < 0.015, P < 0.032, respectively).
For patients with obesity, maintaining a deeper depth of anesthesia during surgery is beneficial to reduce APP causes less need for additional analgesic drugs, and improves patient satisfaction.
肥胖患者对疼痛更敏感，更易发生急性术后疼痛（APP）。研究表明，麻醉深度可能会影响 APP 的发生率。本研究旨在探讨肥胖患者行腹腔镜袖状胃切除术时 APP 与麻醉深度的关系。
这是一项前瞻性、双盲随机临床试验，90 例行腹腔镜袖状胃切除术的患者随机分为两组：浅麻醉组（脑电双频指数 50，BIS 50）和深麻醉组（BIS 35）。术后 0、12、24、48 和 72 h 时采用视觉模拟评分法（VAS）评估疼痛程度。记录镇痛药的使用、术后恶心呕吐（PONV）分级和恢复质量 15 分（QoR-15）评分。
BIS 35 组患者术后 0、12 和 24 h 静息或咳嗽时 VAS 评分低于 BIS 50 组（P < 0.05）。深麻醉组患者在恢复期需要镇痛药物的人数较少，术后第 3 天患者满意度更高（P < 0.015、P < 0.032）。
对于肥胖患者，术中维持较深的麻醉深度有利于减轻 APP，减少对额外镇痛药物的需求，并提高患者满意度。
