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Opioid-free general anaesthesia for transthoracic oesophagectomy: does it improve postoperative analgesia and other recovery criteria? A prospective randomised study

Article

Last updated: 29 Dec 2024

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Abstract

Background
Side effects related to intraoperative opioid administration are well known. Recently, it was found that opioids may inhibit cellular immunity through their effects on natural killer cell activity, stimulate angiogenesis and accentuate cancer cell growth. Hence, peri-operative use of opioids might affect long-term oncological outcomes in cancer surgical patients. Opioid-free anaesthesia (OFA) is a methodology that dodges narcotic use during anaesthesia by using blends of several drugs added to common anaesthetic agents.
Results
The postoperative VAS was significantly lower in OFA group (A) than OBA group (B) in the measured time points (immediate postextubation, 30 min, 2 and 4 h postoperative) with values 0.001, 0.001, 0.0012 and 0.0065 respectively. The time passed till first rescue analgesia requested was significantly longer in OFA group (A) than OBA group (B) and the total dose of rescue analgesia given to the patients were significantly higher in group B than group A. The recorded postoperative respiratory rate was significantly faster in OBA group (B) than OFA group (A), and the haemoglobin oxygen saturation (SPO) showed statistically significant lower values in the OBA group (B) than the OFA group (A).
Conclusions
We emphasise the perioperative safety and efficacy of the opioid-free anaesthesia techniques provided for transthoracic oesophagectomy with better postoperative analgesia and other post recovery criteria.
Trial registration
We carried out our trial at Ain-Shams University Hospitals, Cairo, Egypt, between June 2020 and November 2020. The study was approved by the Research Ethics Committee at the Faculty of Medicine, Ain Shams University and then registered in the Pan African Clinical Trials Registry () with the following ID (PACTR202010907549506).

DOI

10.1186/s42077-021-00170-6

Keywords

Transthoracic oesophagectomy, Opioid-free anaesthesia, Dexmedetomidine, Ketamine, Lidocaine, Opioid-based anaesthesia

Authors

First Name

Tamer Nabil

Last Name

Abdelrahman

MiddleName

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Affiliation

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Email

tamernabil610@gmail.com

City

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Orcid

0000-0002-7923-8550

First Name

Wael Sayed

Last Name

Algharabawy

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

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Volume

13

Article Issue

1

Related Issue

44739

Issue Date

2021-01-01

Receive Date

2021-08-04

Publish Date

2021-08-16

Print ISSN

1687-7934

Online ISSN

2090-925X

Link

https://asja.journals.ekb.eg/article_329716.html

Detail API

https://asja.journals.ekb.eg/service?article_code=329716

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329,716

Publication Type

Journal

Publication Title

Ain-Shams Journal of Anesthesiology

Publication Link

https://asja.journals.ekb.eg/

MainTitle

Opioid-free general anaesthesia for transthoracic oesophagectomy: does it improve postoperative analgesia and other recovery criteria? A prospective randomised study

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Type

Article

Created At

20 Dec 2024