الفهرس 
METHODOLOGYOnly 14 pages are availabe for public view
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Abstract
Bariatric Surgeries are surgeries performed for morbid obese patient to reduce patient’s weight through several methods and because morbid obese patients are at higher risk of complications after surgery, Pain control during bariatric surgery is a major challenge.Opioids play an important role in anesthesia practice; however, related complications like; sedation, airway obstruction, and respiratory depression are of concern in morbid obese patients.Therefore, opioids should be used sparingly.
In this systematic review the literature was reviewed to cover the gab of knowledge regarding the evidence of the safest and most efficient method to control perioperative pain in bariatric surgeries and thirty studies were found related to this topic.
It was found that the most effective method is multi modal analgesia represented in preoperative ultra sound guided TAP block, intraoperative port- sites and intraperitoneal infiltration with local anesthesia then recovery by sugammadex followed by postoperative IVI acetaminophen and PCA. Using preoperative clonidine, ketamine, pregabalin, epidural analgesia and pulmonary recruitment maneuver at the end of the surgery are also with low complication. Continuous infusion catheter, IV Ibuprofen, combined Dexmedetomidine and Acetaminophene, preoperative port-site infiltration and post operative intraperitoneal local anesthetic have no evidence based efficacy right now and it needs further studies.