Background

Pain control is one of the most challenging problems encountered in postoperative period in bariatric surgery patients. Osteopathic Manipulative Treatment (OMT) is considered as a potential cost-effective adjunct. Currently, there is no published data evaluating the effect of OMT on postoperative pain in bariatric surgery patients. The primary objective of this study is to determine whether combination of Osteopathic Manipulative Treatment (OMT) with standard postoperative regimen can decrease postoperative morphine equivalents requirements in 24 hours. The secondary outcomes were pain scores and hospital length of stay. A single center prospective randomized, group controlled study. This study has been registered at ClinicalTrials.gov (ID: NCT03833011). Setting: A 293-bed teaching hospital.

Methods

49 patients underwent laparoscopic sleeve gastrectomy from January 2017 to August 2018 were included into study and randomized to receive either a single session of OMT administered postoperatively and Morphine PCA (n=24) vs Morphine PCA only (n=25). Total parenteral morphine equivalents (PME), pain scores within 24 h postoperatively and length of stay (LOS) were analyzed.

Results

There was less opioid consumption in OMT group 26.9±16.4mg compared to Control 35.1±23.4mg, but it was not statistically significant (p=0.17). There was no difference in pain scores (p=0.32) or median LOS (p=0.48).

Conclusions

This is the first prospective randomized study evaluating OMT as adjunct to reduce postoperative pain after laparoscopic sleeve gastrectomy. Although our study showed less opioid consumption in intervention group, it was not statistically significant. Further studies with larger sample size may show significant reduction in opioid consumption.