69672

Opioid Free Anesthesia in Laparoscopic Cholecystectomy (Comparative Clinical Study)

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Last updated: 03 Jan 2025

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Abstract

Background: Opioid Free Anesthesia aims to avoid perioperative opioids, instead uses adjuvant agents for their opioid-sparing effect which could also affect recovery rates and hospital length of stay (LOS). Patients and Methods: This prospective, randomized, single-blinded clinical study included 62 patients aged between 21 to 50 years, scheduled for LC. Group OA (n=31) received OA with fentanyl as the main anesthetic adjuvant and peri-operative analgesic. Group OFA (n=31) received OFA with dexmedetomidine, ketamine, and paracetamol as an anesthetic adjuvant and peri-operative analgesics. The intraoperative assessment included HR, systolic, diastolic and mean BP, the need for rescue analgesia or ephedrine. The postoperative assessment included the same values plus VAS score, Aldrete score, duration of stay in PACU, the incidence of side effects and complications and hospital LOS. Results: No significant difference between both groups regarding intraoperative hemodynamic values. In the group, OA 22 patients (70.9%) required intraoperative rescue analgesia (with mean dose 55.6 ± 37.4µg, median 70µg and highest dose of 100µg) compared to none in group OFA. In the group, OA 10 (32.3%) patients had PONV compared to 3 (9.7%) patients from group OFA which was statistically significant (P-value 0.033). No significant difference between both groups regarding postoperative VAS score, analgesic requirement, discharge time from PACU or LOS. Conclusions: The study showed that OFA was as effective as OA in maintaining intraoperative hemodynamic stability although group OFA showed the lower need for intraoperative analgesia. OFA also showed a significant reduction of incidence of PONV compared to group OA.

DOI

10.21608/ejhm.2020.69672

Keywords

OFA, Opioid, Fentanyl, Dexmedetomidine, Ketamine, Multimodal, Analgesia, PONV, LOS

Authors

First Name

Osama Helal

Last Name

Ahmed

MiddleName

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Affiliation

Department of Anesthesiology & Intensive Care Faculty of Medicine, Al Azhar University (Assuit)

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First Name

Tawfik Mohammed

Last Name

Noor El-Din

MiddleName

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Affiliation

Department of Anesthesiology & Intensive Care, Faculty of Medicine, Al Azhar University (Cairo)

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Orcid

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First Name

Waheed Mohamed

Last Name

Ali

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Affiliation

Department of Anesthesiology & Intensive Care Faculty of Medicine, Al Azhar University (Assuit)

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First Name

Zeinab Mustafa

Last Name

Sayed

MiddleName

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Affiliation

Department of Anesthesiology & Intensive Care, Faculty of Dentistry and Oral Medicine, South Valley University

Email

zainab.mustafa@dent.svu.edu.eg

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Orcid

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Volume

78

Article Issue

1

Related Issue

10074

Issue Date

2020-01-01

Receive Date

2020-02-01

Publish Date

2020-01-01

Page Start

200

Page End

211

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_69672.html

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https://ejhm.journals.ekb.eg/service?article_code=69672

Order

29

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Opioid Free Anesthesia in Laparoscopic Cholecystectomy (Comparative Clinical Study)

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Article

Created At

22 Jan 2023