Challenges in the Optimisation of Post-operative Pain Management with Opioids in Obese Patients: a Literature Review

被引：40

作者：

Lloret-Linares, C. ^{[1
,2
]}

Lopes, A. ^{[1
]}

Decleves, X. ^{[2
]}

Serrie, A. ^{[2
,3
]}

Mouly, S. ^{[1
,2
]}

Bergmann, J. -F. ^{[1
,2
]}

Perrot, S. ^{[4
,5
]}

机构：

[1] Univ Paris 05, Fac Pharm, INSERM U705, CNRS UMR Neuropsychopharmacol Drug Addict 8206, F-75006 Paris, France

[2] Hop Lariboisiere, AP HP, Unit Therapeut Res, Dept Internal Med, F-75010 Paris, France

[3] Hop Lariboisiere, Ctr Traitement & Evaluat Douleur, AP HP, F-75010 Paris, France

[4] Hop Cochin Hotel Dieu, AP HP, Ctr Traitement & Evaluat Douleur, F-75004 Paris, France

[5] Hop Ambroise Pare, INSERM Physiopharmacol Douleur U987, F-92100 Paris, France

来源：

OBESITY SURGERY | 2013年 / 23卷 / 09期

关键词：

Morphine; Obesity; Post-operative pain; Surgery; Analgesia; LAPAROSCOPIC BARIATRIC SURGERY; GASTRIC BYPASS-SURGERY; TOTAL KNEE ARTHROPLASTY; MORBIDLY OBESE; CONTROLLED ANALGESIA; WEIGHT-LOSS; TRANSPORTER EXPRESSION; PULMONARY-FUNCTION; RANDOMIZED-TRIAL; MOUSE MODEL;

D O I：

10.1007/s11695-013-0998-8

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

An increasing number of obese patients are undergoing surgery, particularly bariatric and orthopaedic surgery. The physiological differences between obese and normal-weight subjects may modify not only anaesthetic requirements during surgery but also post-operative analgesic management, raising a number of challenges in a critical period. In this review, we analyse studies of post-operative pain management with opioids in obese subjects. We discuss the genetic factors common to pain and obesity and the factors potentially modifying opioid pharmacokinetics and pharmacodynamics in obese patients, and we analyse the overall efficacy and safety of opioids for pain management during the post-operative period in obese patients. Both modifications to surgical methods and additional analgesic treatments to decrease the requirement for opioids may improve early rehabilitation and quality of care and reduce adverse effects in obese patients.

引用

页码：1458 / 1475

页数：18

共 83 条

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