Analgesic medication considerations for chronic pain management post-bariatric surgery.
Sumani VijAdriana TooVictor TsangDenise KreutzwiserPublished in: Expert opinion on drug metabolism & toxicology (2024)
An individualized medication management approach is ideal for post-bariatric surgery patients, as PK parameters, type of surgery, time since surgery, and patient specific factors make it difficult to support blanket recommendations. Close monitoring of efficacy and safety outcomes is essential in chronic pain management. While the PK of acetaminophen and opioids are impacted, the value of these medications in the setting of chronic pain is dwindling as more efficacy and safety data emerges. A life-long ban of NSAIDs due to marginal ulcer risk is not endorsed; rather, we advocate for shifting the focus to marginal ulcer prevention strategies, individualized benefit-risk analysis, and safety monitoring using surrogate markers.
Keyphrases
- chronic pain
- pain management
- bariatric surgery
- minimally invasive
- coronary artery bypass
- weight loss
- end stage renal disease
- obese patients
- healthcare
- ejection fraction
- newly diagnosed
- chronic kidney disease
- surgical site infection
- peritoneal dialysis
- adverse drug
- emergency department
- electronic health record
- liver injury
- adipose tissue
- drug induced
- metabolic syndrome
- big data
- anti inflammatory
- deep learning
- data analysis
- machine learning
- clinical practice
- patient reported