Preperitoneal Bupivacaine Infiltration Reduces Postoperative Opioid Consumption, Acute Pain, and Chronic Postsurgical Pain After Bariatric Surgery: a Randomized Controlled Trial

Saskia L. Boerboom*, Ann de Haes, Lianne Vd Wetering, Edo O. Aarts, Ignace M. C. Janssen, Jose W. Geurts, Ed T. Kamphuis

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Introduction A multimodal pain treatment including local anesthetics is advised for perioperative analgesia in bariatric surgery. Due to obesity, bariatric surgery patients are at risk of respiratory complications. Opioid consumption is an important risk factor for hypoventilation. Furthermore, acute postoperative pain is an important risk factor for chronic postsurgical pain. In this study, we aimed to evaluate whether preperitoneal anesthesia with bupivacaine would reduce pain and opioid consumption after bariatric surgery. Methods One hundred adults undergoing laparoscopic bariatric surgery were randomized to receive either preperitoneal bupivacaine 0.5% or normal saline before incision. Postoperative opioid consumption, postoperative pain, and postoperative recovery parameters were assessed for the first 24 h after surgery. One year after surgery, chronic postsurgical pain and influence of pain on daily living were evaluated. Results Postoperative opioid consumption during the first hour after surgery was 2.8 +/- 3.0 mg in the bupivacaine group, whereas in the control group, it was 4.4 +/- 3.4 mg (p = 0.01). Pain scores were significantly reduced in this first hour at rest and at 6 h during mobilization on the ward. One year after surgery, the incidence of chronic postsurgical pain was 13% in the bupivacaine group versus 40% in the placebo group. Conclusion This study shows that preperitoneal local anesthesia with bupivacaine results in a reduction in opioid consumption and postoperative pain and seems to lower the incidence rate of chronic postsurgical pain after laparoscopic bariatric surgery.
Original languageEnglish
Pages (from-to)3102-3110
Number of pages9
JournalObesity Surgery
Issue number10
Publication statusPublished - 1 Oct 2018


  • Local anesthesia
  • Bupivacaine
  • Gastric bypass surgery
  • Postoperative pain
  • Chronic pain
  • Acute pain

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