Opioid pharmacology in obese patients

Abstract

A primary goal in the care of surgery patients is adequate treatment of their perioperative pain. The guidelines from The Joint Commission described the measurement of pain as the ‘fifth vital signal’. Consequently, pain alleviation is a top priority in postoperative management. Most anaesthesiologists worldwide use opioids as one of the primary components of general anaesthesia for achieving haemodynamic stability and for postoperative pain relief. There are medical conditions associated with obesity that must be considered when using postoperative opioids to avoid deleterious effects in these patients. The intraoperative use of opioids is less dangerous but induces rapid tolerance and hyperalgesia, requiring higher postoperative opioid dosages. The physiological differences between obese and non-obese patients can have repercussions on the pharmacokinetics and pharmacodynamics of opioid drug use for this patient population.