The Association of Sex with Pain Scores and Perioperative Opioid Administration Following Laparoscopic Sleeve Gastrectomy

Abstract

Aim: We investigated whether sex is associated with pain scores and opioid administration after laparoscopic sleeve gastrectomy. Materials & methods: We performed a single-center, retrospective analysis of laparoscopic sleeve gastrectomy patients from December 2016–July 2018. Multivariable linear regressions were performed to investigate the association of sex with pain scores and opioid administration. Results: Baseline pain scores were similar between women and men (n = 266; 78% women). Men reported lower pain scores in all phases of care and received more opioids during their hospitalization (ß = 25.48; 95% CI: 5.77–45.20; p = 0.01), compared with women. Conclusion: Our data suggest that women self-report greater postoperative pain scores, while men received more opioids during their hospitalization. Further studies are needed to understand the reasons for such differences in postoperative pain management.

Lay abstract

Men are at higher risk for long-term opioid use compared with women, but it remains unclear whether perioperative management is a sentinel event for such outcomes. Since patients who receive higher amounts of postoperative opioids are more likely to remain on long term narcotics, we investigated whether sex is associated with pain scores and opioid administration after bariatric surgery. We demonstrate that men self-report lower pain scores in the postanesthesia care unit, surgical floor and at discharge, compared with women. We also show that while men and women received comparable doses of opioids in the operating room and postanesthesia care unit, men received more opioids on the surgical floor. Our findings suggest that strategies to reduce opioid administration after bariatric surgery should largely focus on care after the immediate postoperative period.

Keywords::

• gender
• obesity
• opioid
• pain
• sex
• surgery

Financial & competing interests disclosure

SA Quraishi received consulting fees and research funding from Abbott Nutrition, Alcresta Therapeutics and Fresenius Kabi not related to the current manuscript. R Schumann receives royalties from UpToDate as well as Wolters Kluwer as a reviewer and author of two obesity-related chapters. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate Institutional Review Board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

SA Quraishi received consulting fees and research funding from Abbott Nutrition, Alcresta Therapeutics and Fresenius Kabi not related to the current manuscript. R Schumann receives royalties from UpToDate as well as Wolters Kluwer as a reviewer and author of two obesity-related chapters. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.