British Journal of Anaesthesia, Vol 80, Issue 3 283-288, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
J. L. Joris, V. L. Hinque, P. E. Laurent, C. J. Desaive and M. L. Lamy
We have compared severely obese patients (body mass index > 35 kg m-2)
undergoing laparoscopic or open gastroplasty (n = 15 in each group) to
determine if laparoscopy results in any benefit in the obese. Postoperative
pain, measured on a 100-mm visual analogue scale, and opioid consumption
were recorded during the first two days after operation. Tests of pulmonary
function were performed and SpO2 was measured 4 h after surgery and on days
1, 2 and 3 after operation. Pain at rest was similar in the two groups, but
in the laparoscopy group, requirements for postoperative opioid were 50%
less (P < 0.05). Pain intensity during mobilization and on coughing was
significantly less after laparoscopy (differences between mean pain scores
in both groups ranged from 20 to 32 mm during mobilization and from 32 to
34 mm during coughing). Forced vital capacity, forced expiratory volume in
1 s and peak expiratory flow rate were reduced significantly less after
laparoscopic gastroplasty than after open gastroplasty (on day 1 forced
vital capacity was reduced by 50% compared with 64%, forced expiratory
volume in 1 s was reduced by 50% compared with 66% and peak expiratory flow
rate by 45% compared with 60%). SpO2 values were significantly greater in
the laparoscopy group (day 1: mean 95 (SD 2)% vs 91 (5)%; day 3: 97 (1)% vs
94 (3)%). This study suggests that the beneficial effects observed after
laparoscopic gastroplasty in morbidly obese patients were similar to those
reported after laparoscopic cholecystectomy in non-obese patients.
CLINICAL INVESTIGATIONS
Pulmonary function and pain after gastroplasty performed via laparotomy or laparoscopy in morbidly obese patients
Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Liege, Belgium; Department of Gastrointestinal Surgery, University Hospital of Liege, Belgium
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