Pain medication after bariatric surgery

General guidelines for pain relievers:

– Use the lowest effective dose for the shortest possible duration

– Do not mix alcohol with any pain relievers

– Store pain relievers out of reach of children, preferably locked up

– Always store pain relievers in their original packaging to avoid confusion

– Return morphine-like pain relievers to the pharmacy when you no longer need them. Around 5% of those who have never used morphine-like pain relievers before surgery are likely to still be using them one year after the procedure. The chances of such misuse are very low if these strong pain relievers are used for 5 days or less.

Pain relievers in connection with the surgery and in the ward:

– During the surgery, you will receive several types of pain relievers to prevent severe pain when you wake up. In most cases, strong morphine-like pain relievers (Fentanyl) and anti-inflammatory drugs (Toradol) are administered. Local anesthetics are also used during the procedure, reducing the need for strong pain relievers in the first hours after surgery.

– It is highly individual how severe the pain is during the first hours after surgery. Nurses in the recovery and ward assess the need for pain relievers, which are administered as needed.

– You will be prescribed Panodil (paracetamol) in connection with the surgery. If

we assess the pain in the ward as severe, you will get strong (morphine-like) pain relievers to take home for 1-2 days. In most cases, this is sufficient, and being prescribed stronger pain relievers is an exception.

– It is normal to experience pain following the surgery. The goal of pain management is to reduce the pain so that you can move easily and take deep breaths.

Subsequent use of pain relievers in individuals who have undergone bariatric surgery

Panodil (paracetamol): A good first-choice pain reliever that also has fever-reducing effects. Must be used with caution if liver disease is present. Can cause liver damage if used in excessive amounts. Generally, adults are advised not to exceed 4,000 mg per day.

Traditional anti-inflammatory drugs (e.g., ibuprofen, naproxen, voltaren), so-called NSAIDs: Have anti-inflammatory and pain-relieving effects. These drugs may be used for a short period, such as for menstrual cramps or headaches. Long-term use should be avoided due to the risk of side effects. Common side effects include stomach ulcers, which can then cause bleeding or perforation of the stomach or bowel, requiring hospital treatment. This type of anti-inflammatory drug is particularly hazardous after bypass surgeries where there is an increased risk of ulcers at the junctions with the small intestine.

Newer types of anti-inflammatory drugs (e.g., celebra or arcoxia), so-called COX2 inhibitors: This type of anti-inflammatory pain reliever is more suitable when long-term use is necessary, e.g., for chronic musculoskeletal pain. The incidence of stomach ulcers is lower than when NSAIDs are used.

Neuropathic pain medications (e.g., Gabapentin) are used for nerve pain. Bariatric surgeries do not directly affect the use of these pain relievers, and they can therefore be used according to recommendations if applicable.

Morphine-like pain relievers (Tradolan, Oxynorm, Oxycontin, Parkodin, etc.): Strong pain relievers with many side effects. These drugs should only be used for very severe pain and only for a short time. The main side effects are nausea, constipation, headache, dizziness, fatigue, itching, reduced respiratory rate, or respiratory drive. High risk of addiction, misuse, and overdose, which can lead to death due to low respiratory rate.