Analgesia Management in Bariatric Surgery
Condition: Morbid Obesity; Bariatric Surgery Candidate; Pain; Postoperative
MeSH terms: Obesity, Morbid
Study type: Interventional

Summary: 
      Following laparoscopic bariatric surgery, multimodal analgesia is recommended to avoid the
      adverse effects of opioids by reducing their use. Although lidocaine, ketamine, and
      dexmedetomidine have been used as adjuvant analgesics, no studies have evaluated the
      superiority of their intra- and postoperative infusions as components of multimodal analgesia
      in bariatric surgery. The present study is aimed to compare lidocaine, dexmedetomidine, and
      ketamine in multimodal analgesia management following Sleeve Gastrectomy Surgery.
      Postoperative pain scores, the requirement for additional postoperative analgesia, retching,
      nausea and vomiting, time to mobilization, and hospital length of stay will be evaluated.
    

Detailed description: 
      Patients will be divided into three groups.

      Group L: The patients will receive intravenous lidocaine (2 mg/kg/h) immediately after
      anesthesia induction. At the end of the surgery, the dose will be decreased to 1 mg/kg/h. The
      infusion will continue until 12 hours after the operation.

      Group K: The patients will receive intravenous ketamine (0.5 mg/kg/h) immediately after
      anesthesia induction. At the end of the surgery, the dose will be decreased to 0.3 mg/kg/h.
      The infusion will continue until 12 hours after the operation.

      Group D: The patients will receive intravenous dexmedetomidine (0.5 mg/kg/h) immediately
      after anesthesia induction. At the end of the surgery, the dose will be decreased to 0.3
      mg/kg/h. The infusion will continue until 12 hours after the operation.

      Ketamine, lidocaine, and dexmedetomidine doses will be calculated according to ideal body
      weight, lean body weight, and actual body weight, respectively.

      Randomization will be performed using a computer-generated random number list, and a
      statement indicating the patient's group will be placed in a closed envelope numbered
      according to the result. Each patient will be asked to choose an envelope, and the patients
      will be assigned to the study according to the group mentioned in the envelope.
    

Intervention name(s): Lidocain; Ketamine; Dexmedetomidine
Intervention type(s): Drug; Drug; Drug
Intervention description(s): IV lidocaine infusion (2 mg/kg/h) will be initiated after anesthesia induction and decrease the dosage to 1 mg/kg/h at the end of surgery. The infusion will continue until 12 hours after the operation.1 g paracetamol, 100 mg tramadol, 100 mg ketoprofen, and 4 mg dexamethasone will be administered to all patients pre-emptively. Granisetron (3 mg) will be administered 30 minutes before the end of surgery. In the postoperative period, i.v. Paracetamol will be administered at 8-hour intervals and 25-50 mg meperidine i.m. (maximum dose 200 mg) as rescue analgesia when requested by the patient and if VAS>4.; IV ketamine infusion (0.5 mg/kg/h) will be initiated after anesthesia induction and decrease the dosage to 0.3 mg/kg/h at the end of surgery. The infusion will continue until 12 hours after the operation.1 g paracetamol, 100 mg tramadol, 100 mg ketoprofen, and 4 mg dexamethasone will be administered to all patients pre-emptively. Granisetron (3 mg) will be administered 30 minutes before the end of surgery. In the postoperative period, i.v. Paracetamol will be administered at 8-hour intervals and 25-50 mg meperidine i.m. (maximum dose 200 mg) as rescue analgesia when requested by the patient and if VAS>4.; IV dexmedetomidine infusion (0.5 mg/kg/h) will be initiated after anesthesia induction and decrease the dosage to 0.3 mg/kg/h at the end of surgery. The infusion will continue until 12 hours after the operation.1 g paracetamol, 100 mg tramadol, 100 mg ketoprofen, and 4 mg dexamethasone will be administered to all patients pre-emptively. Granisetron (3 mg) will be administered 30 minutes before the end of surgery. In the postoperative period, i.v. Paracetamol will be administered at 8-hour intervals and 25-50 mg meperidine i.m. (maximum dose 200 mg) as rescue analgesia when requested by the patient and if VAS>4.
Intervention MeSH terms: Lidocaine; Dexmedetomidine; Ketamine
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The patients will be randomly classified into three groups.
Masking: Double (Participant, Investigator)
Primary purpose: Supportive Care
Keywords: Dexmedetomidine; Ketamine; Lidocaine; Obesity; Morbid; Pain; Postoperative