Pain and Therapy · Published 2026-03-24 · DOI 10.1007/s40122-026-00829-8
Abstract Introduction The rising global prevalence of obesity has established bariatric surgery as a key therapeutic option; however, postoperative pain management remains a challenge. This study investigated the influence of body mass index (BMI) stratification on acute postoperative pain in patients undergoing bariatric surgery. Methods Fifty-five patients aged 18–65 years with BMI ≥ 30 kg/m2 scheduled for laparoscopic sleeve gastrectomy were categorized into the obesity group (O group; 30 kg/m2 ≤ BMI < 40 kg/m2) and the severe obesity group (SO group; BMI ≥ 40 kg/m2). Preoperative pain threshold and pain tolerance threshold, perioperative inflammatory cytokines, Brief Pain Inventory (BPI) scores, Quality of Recovery-15 (QoR-15) scores, postoperative resting and movement numeric rating scale (NRS) scores, patient-controlled analgesia (PCA) pump usage, cumulative analgesic consumption, and analgesic satisfaction were assessed. Results Compared with the O group, the SO group demonstrated a significantly higher pain tolerance threshold (4.1 ± 0.8 vs. 3.5 ± 1.0, P < 0.01), along with lower demand for PCA and reduced consumption of cumulative morphine milligram equivalents and flurbiprofen (P < 0.05). Notably, the primary outcome, the 24-h BPI score, showed no significant difference between the two groups. On postoperative days 1 and 3, tumor necrosis factor-α (TNF-α) levels were significantly lower in the O group, whereas no significant intergroup differences were observed in other inflammatory cytokines. No significant differences were observed in NRS or QoR-15 scores between the two groups. Conclusion BMI may be considered as a factor for stratifying postoperative analgesia, favoring multimodal, opioid-sparing strategies in patients with severe obesity who demonstrate higher pain tolerance and lower analgesic requirements. Trial Registration Chinese Clinical Trial Registry, ChiCTR2400095080.
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →