THE EVALUATION OF THE RISK OF COMPLICATIONS DURING MULTIMODAL AND OPIOID ANESTHESIA IN BARIATRIC SURGERY AND ABDOMINOPLASTY.

The use of opioids for anesthesia during surgery is associated with side effects. The aim of our study is to assess the risk of postoperative pain during multimodal and opioid anesthesia in bariatric surgery and abdominoplasty. The study observed 127 patients (93 women, 34 men) aged 20-70 who underwent bariatric surgery and abdominoplasty. Two groups were formed: Group I received standard anesthesia with opioids, while Group II underwent multimodal anesthesia without opioids. Standard anesthesia with opioids was administered to 49 patients - group I, multimodal anesthesia without opioids - 78 - group II. During the operation the use of opioids reduces the risk of non-opioid necessity and increases the risk of opioid usage. During the anesthesia using multimodal anesthesia and in the postoperative period, in the in-hospital stage, there is an increased risk of non-opioid necessity, whereas in the ambulatory stage, there is an increased risk of medical care necessity. There is positive significant correlation between Anesthesia using multimodal anesthesia during surgery with: Phase 1,PACU 1 - r=0.608**, p<0.001; Phase 1, PACU 2 - r=0.287**, p=0.001 and negative significant correlation with I Phase 1, PACU 3 - r=-0.779**, p<0.001;There is positive significant correlation between Anesthesia using multimodal anesthesia during surgery with: Phase 2, PACU 1 - r=0.950**, p<0.001and negative significant correlation with Phase 2, PACU 2 - r=-0.234**, p=0.008; Phase 2,PACU 3 - r=-0.871**, p<0.001. Anesthesia using opioids during surgery, compared to multimodal anesthesia, increases the relative risk of needing both non-opioid RR=0.35 (95% CI:0.17-0.71),and opioid treatment -RR=3.86 (95% CI:2.68-5.56), in the postoperative period in the hospital stage- Requires non-opioid medical treatment - RR=13.06 (95% CI:.03-28.29), Needs opioids- RR=7.50 (95% CI:4.43-12.70). The relative risk of needing medical treatment in the ambulatory stage - RR=3.11 (95% CI:2.23-4.32). Multimodal anesthesia in bariatric surgery and abdominoplasty reduces the duration of postoperative care and the use of opioids after surgery.