OpioidFreeGeneralAnesthesiafor LaparoscopicBariatricSurgery

Abstract

The need for bariatric surgery is rapidly increasing and the concept of fast-track surgery and laparoscopy have made bariatric surgery a cost-effective and efficient way of treating the morbidly obese when other non-surgical options have been unsuccessful. Bariatric surgery is effective in reducing obesity related co -morbidities as well as achieving major long-term weight loss and improvement in quality of life. Compared with conservative management, bariatric surgery leads to a 29% reduction in the long-term risk of death. Laparoscopic approach has emerged as a popular alternative to traditional open abdominal surgery as it combines the benefits of less post operative pain and ileus and less deterioration of postoperative respiratory functions with subsequent shorter postoperative hospital stay and rapid return to normal activities. However, laparoscopic surgeries are associated with hemodynamic, ventilatory and neuroendocrinal changes which result from the combined effects of pneumoperitoneum, hypercapnia secondary to CO2 absorption, anesthesia technique and patient position.