Visceral Block in Bariatric Surgery: A Pilot Double Blind Randomized Clinical Study

BACKGROUND: Local anesthetics are used in various sites and mechanisms to maximize perioperative analgesia and reduce opioid use and side effects. Pain management in the bariatric setting is challenging and the efficacy of local anesthetics intraoperatively is under current evaluation. OBJECTIVES: To determine the safety and efficacy of a new intra-abdominal anesthetic technique performed during laparoscopic bariatric operations: visceral block. METHODS: During this prospective randomized double-blinded pilot study, 16 patients undergoing bariatric surgery were treated with the injection of ropivacaine to the anterior esophagogastric junction fat, and 15 were injected with saline as control. RESULTS: The procedure was shown to be safe, and no adverse events nor side effects were encountered. A non-statistically significant trend toward the use of a non-opioid analgesia was documented during the first postoperative hours. CONCLUSIONS: Visceral block is a safe and feasible intraoperative procedure. A trend toward its efficacy warrants future larger scale studies.