Association Between Body Mass Index and Acute Postoperative Pain Following Laparoscopic Cholecystectomy: A...

Obesity has been increasingly recognized as a factor associated with altered pain perception and postoperative analgesic requirements; however, its relationship with acute postoperative pain following laparoscopic cholecystectomy remains incompletely defined. This retrospective observational study investigated the association between body mass index (BMI) and acute postoperative pain severity in adult patients undergoing elective laparoscopic cholecystectomy. Ninety-six patients were categorized into obese and non-obese groups according to BMI criteria for Chinese adults. Demographic characteristics, perioperative variables, postoperative numeric rating scale (NRS) pain scores at multiple time points, and opioid consumption converted to oral morphine equivalents (OME) were collected from medical records. Multivariable logistic regression was used to evaluate the association between BMI and moderate-to-severe postoperative pain, defined as a 24 h mean NRS score ≥4. Compared with non-obese patients, obese patients had higher NRS scores at 6 h, 12 h, and 24 h after surgery, higher first NRS scores in the post-anesthesia care unit, and greater postoperative opioid consumption. In the adjusted regression model, continuous BMI was independently associated with moderate-to-severe postoperative pain after adjustment for age, sex, American Society of Anesthesiologists classification, and intraoperative opioid consumption. These findings suggest that elevated BMI is associated with greater acute postoperative pain severity and analgesic requirements after laparoscopic cholecystectomy. BMI-informed perioperative risk assessment may help guide individualized postoperative pain management in this patient population.