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Background Postoperative pain contributes to opioid use. Physicians struggle to limit the prescription of opioids post-operatively and upon discharge. The side effect of respiratory depression is concerning in obese patients, particularly those undergoing bariatric surgery, because they often suffer from sleep apnea and other restrictive lung diseases. This research studies the effects of a novel multimedia program delivered via a tablet device on pain-related outcomes in patients recovering from bariatric surgery.
Methods Patients scheduled for vertical sleeve gastrectomy (VSG) or Roux-en-Y gastric bypass (RYGB) surgery were randomized into an experimental (A) and control group (B). Group A received an iPad programmed with an educational video and four applications. Group B received the standard entertainment options. Pain scores, opioid medication use, and BMI were monitored inpatient and at follow-up visits. Tablet usage time in Group A was monitored, and both groups completed exit surveys about the interventions. Candidates were screened until 48 subjects were enrolled, 23 in Group A and 25 in Group B (control). All patients received an intraoperative transversus abdominis block and an oral regimen including acetaminophen, celecoxib, and tramadol; patients were discharged on tramadol 50-100 mg every 6 hours as needed for 28 days.
Results • Question 1: mean response was 1.88/4 with a standard deviation of 1.05 (p = 0.721). • Question 2: 3/17 patients stated that the usage of the tablet helped with pain (p = 1.000). 7/17 stated that the usage of the tablet helped with anxiety (p = 1.000). 4/17 stated that it helped with sleep (p = 0.738). 6/17 stated that it helped with mood (p = 0.494). 4/17 endorsed it helping with unpleasant thoughts (p = 1.000). • Question 3: 5/17 stated that the tablet helped with less pain medication use. 12/17 stated that it did not (p = 0.197). • Question 4: 16 responded yes and 1 responded no (p = 1.000). • Question 5: 8 responded yes and 9 responded no (p = 0.014). • Question 6: the mean was 2.0/4.0 with a standard deviation of 1.41, and the range was 0-3 (p = 0.211).
Conclusion Multimedia helped with all the areas queried, including crucial postoperative factors such as pain, anxiety, and sleep. The limitation of this study was the inability to control the multimedia resources that patients brought to the hospital on their own. All patients found multimedia to be at least “probably” helpful in the postoperative setting, with the control group continuing to use similar approaches at home.
