The World Health Organization declared obesity as the most dangerous chronic disease, which if left untreated leads to the development of cardiovascular disease, type 2 diabetes, metabolic syndrome, hormonal disorders, and also increase in the incidence of certain types of cancer. Along with the progress of civilization and the improvement of living conditions in developed countries, the number of obese people is increasing. This problem also applies to the Polish population. Research (TNS in August 2008), shows that in Poland 46 percent of the population are overweight or obese. According to Eurostat data (in November last year, in 2008-2009) in Poland was 16 percent of obese women and 17 percent of obese men. Normal BMI (Body Mass Index) is calculated by dividing weight in kilograms by height in meters the normal range for adult should be within 18.5 and 24.9. Overweight is recognized when BMI is between 25.0 and 29.9. According to WHO guidelines, there are three degrees of obesity: I – BMI 30.0-34.9; II – BMI: 35.0-39.9 and III – BMI > 40.0. The third degree of obesity is sometimes called as morbid obesity. There are many methods of weight reduction, including: diet, increased physical activity, psychotherapy, pharmacotherapy (1). The increasing popularity of surgical treatment of obesity is laparoscopic gastrectomy (sleeve gastrectomy) (2). Effective and safe treatment of perioperative pain in the obese is a major challenge for the anaesthesiologist (3). Increased body weight, residual effects of drugs used during anaesthesia and altered anatomical conditions conducive to the development of postoperative respiratory failure (4, 5). Abdominal surgery is associated with the onset of pain as visceral, requiring effective analgesia (6). Visceral pain is a significant problem in the treatment, it is often difficult to determine its severity and precise location, and it may be transferred to other areas of the body. Pain in the abdomen, even at very high intensity, it can be very disruptive for the patient and often harder to accept than the pain of another location. In this situation currently guidelines recommend the use of opioids (7). A good method for postoperative analgesia in obese patients is the method of administration of drugs into the epidural space, which for technical reasons it is often difficult to apply. One of the drugs prescribed for the treatment of postoperative pain in obese patients is oxycodone, which has a good clinical effect in bariatric patients (8, 9). Physical and chemical properties and pharmacokinetics of oxycodone are similar to morphine. Research indicates that the use of oxycodone provides better analgesia compared to other opioids and causes fewer side effects (9).

The aim of the study is to present our preliminary observations concerning the efficacy and safety of pain management in the postoperative period in patients undergoing laparoscopic sleeve gastrectomy.