Maria C Fonseca, MD, Cristian Milla Matute, MD, Camila Ortiz Gomez, MD, Francisco Ferri, MD, Emanuele Lo Menzo, MD, PhD, FACS, FASMBS, Samuel Szomstein, MD, FACS, FASMBS, Raul J Rosenthal, MD, FACS, FASMBS. Cleveland Clinic Florida
Background: Unbearable pain associated with symptomatic Osteoarthritis(OA) is among the causes of work loss worldwide. Schedule II/III opioids are frequently used for this purpose, however is highly associated to abuse. The aim of this study is to describe OA in our population and the opioid reduction and cessation after undergoing Bariatric Surgery.
Methods: After IRB approval, we performed a retrospective analysis of all severely obese patients with a BMI above 35 kg/m2 and Osteoarthritis who underwent bariatric surgery from January 2004 to February 2018 at our institution. OA remission was assessed by the decrease in the dose of opioid medication for pain management or cessation during 6 and 12 months. Patients were matched for demographics. We excluded patients who received opioids due to Polymyalgia rheumatic and fibromyalgia.
Results: From 4226 patients, 11%(N=483) met the inclusion criteria. Female gender was predominant (N=335; 69.4%). Average BMI was 43.93+/-8.8kg/m2. Performed surgeries were as follows: LSG in 43.8%(N=213) patients, RYGB in 39.9%(N=194) patients and AGB in 16.1%(N=78) patients (table 1). Remission was achieved in 95%(N=495) and 97%(N=471) of the patients at 6 and 12 months respectively. Overall statistical significance was attributed to Opioid dose reduction at 6 and 12 months was found in 54.2%(N=13) and 75%(N=9) (p=0.02 and P=0.06) respectively, when compared to preoperatively. Oxycodone was predominantly prescribed at 6 months in 54.2%(N=13) and 12 months in 41.7%(N=5) of the patients, with no statistical difference among procedures(p=0.15 in both terms) (Table 2).
Conclusion: In spite of the discriminated consumption of opioids for pain control, Bariatric Surgery seems to reduce substantially their use, by achieving OA remission in 97% of our patients at 12 months. Further studies will need to be done to confirm these findings.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95443
Program Number: P103
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster