This retrospective observational study aimed to compare the effects of epidural analgesia and intravenous analgesia on early postoperative pulmonary function in patients undergoing laparoscopic sleeve gastrectomy. Preoperative and postoperative pulmonary function tests, pain scores, opioid consumption, and intraoperative respiratory parameters were evaluated.

This retrospective observational study was conducted at Trabzon Kanuni Training and Research Hospital. Adult patients who underwent laparoscopic sleeve gastrectomy between January 2025 and October 2025 were included. Patients were divided into two groups according to postoperative analgesia technique: epidural analgesia and intravenous analgesia.

The primary outcome was postoperative change in FEV1 at 24 hours after surgery. Secondary outcomes included changes in FVC and FEV1/FVC ratio, postoperative pain scores, additional opioid consumption, and intraoperative ventilatory parameters including peak airway pressure and plateau pressure.

Demographic data, perioperative variables, pulmonary function test results, arterial blood gas analyses, and analgesia-related data were retrospectively collected from hospital records. The study was approved by the Non-Interventional Scientific Research Ethics Committee of Trabzon University Faculty of Medicine.

Inclusion Criteria:

• Adult patients aged 18-65 years
• ASA physical status III
• Undergoing laparoscopic sleeve gastrectomy
• Availability of preoperative and postoperative pulmonary function tests
• Availability of arterial blood gas analysis data
• Receipt of epidural or intravenous postoperative analgesia

Exclusion Criteria:

• Missing pulmonary function test data
• Incomplete medical records
• Conversion to open surgery
• Severe respiratory disease affecting pulmonary function assessment

Adult obese patients undergoing laparoscopic sleeve gastrectomy at a tertiary training and research hospital.