Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 11, 9

Provider Preferences for Postoperative Analgesia in Obese and Non-Obese Patients Undergoing Ambulatory Surgery


Provider Preferences for Postoperative Analgesia in Obese and Non-Obese Patients Undergoing Ambulatory Surgery

Anthony H Bui et al. J Pharm Policy Pract.


Background: Few guidelines exist on safe prescription of postoperative analgesia to obese patients undergoing ambulatory surgery. This study examines the preferences of providers in the standard treatment of postoperative pain in the ambulatory setting.

Methods: Providers from five academic medical centers within a single US city were surveyed from May-September 2015. They were asked to provide their preferred postoperative analgesic routine based upon the predicted severity of pain for obese and non-obese patients. McNemar's tests for paired observations were performed to compare prescribing preferences for obese vs. non-obese patients. Fisher's exact tests were performed to compare preferences based on experience: > 15 years vs. ≤15 years in practice, and attending vs. resident physicians.

Results: A total of 452 providers responded out of a possible 695. For mild pain, 119 (26.4%) respondents prefer an opioid for obese patients vs. 140 (31.1%) for non-obese (p = 0.002); for moderate pain, 329 (72.7%) for obese patients vs. 348 (77.0%) for non-obese (p = 0.011); for severe pain, 398 (88.1%) for obese patients vs. 423 (93.6%) for non-obese (p < 0.001). Less experienced physicians are more likely to prefer an opioid for obese patients with moderate pain: 70 (62.0%) attending physicians with > 15 years in practice vs. 86 (74.5%) with ≤15 years (p = 0.047), and 177 (68.0%) attending physicians vs. 129 (83.0%) residents (p = 0.002).

Conclusions: While there is a trend to prescribe less opioid analgesics to obese patients undergoing ambulatory surgery, these medications may still be over-prescribed. Less experienced physicians reported prescribing opioids to obese patients more frequently than more experienced physicians.

Conflict of interest statement

The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Similar articles

See all similar articles


    1. Wheeler M, Oderda GM, Ashburn MA, Lipman AG. Adverse events associated with postoperative opioid analgesia: a systematic review. J Pain. 2002;3(3):159–180. doi: 10.1054/jpai.2002.123652. - DOI - PubMed
    1. Oderda G. Challenges in the management of acute postsurgical pain. Pharmacotherapy. 2012;32(9 Suppl):6S–11S. doi: 10.1002/j.1875-9114.2012.01177.x. - DOI - PubMed
    1. Pattinson KTS. Opioids and the control of respiration. Br J Anaesth. 2008;100(6):747–758. doi: 10.1093/bja/aen094. - DOI - PubMed
    1. Alam A, Gomes T, Zheng H, Mamdani MM, Juurlink DN, Bell CM. Long-term analgesic use after low-risk surgery: a retrospective cohort study. Arch Intern Med. 2012;172(5):425–430. doi: 10.1001/archinternmed.2011.1827. - DOI - PubMed
    1. Clarke H, Soneji N, Ko DT, Yun L, Wijeysundera DN. Rates and risk factors for prolonged opioid use after major surgery: population based cohort study. BMJ. 2014;348:g1251. 10.1136/bmj.g1251. Accessed 30 Mar 2016 - PMC - PubMed

LinkOut - more resources