Beta
387957

The perioperative analgesic effect of opioid free anesthesia using combination of dexmedetomidine, ketamine and lidocaine in adolescent patients undergoing Scoliosis Surgery; A r

Article

Last updated: 05 Jan 2025

Subjects

-

Tags

-

Abstract

Background
Posterior spinal fusion treatment is one of the most painful options accessible to teenagers with idiopathic scoliosis.
Objectives
This study evaluated the opioid-sparing anesthesia analgesic effect using a combination of dexmedetomidine, ketamine and lidocaine versus opioid-based anesthesia (OBA) with fentanyl in adolescent patients undergoing scoliosis surgery.
Methods
This prospective, double-blinded, randomized study was conducted on 50 patients, American Society of Anesthesiologists (ASA) physical state I–II, scheduled for surgical correction of adolescent idiopathic scoliosis under general anesthesia. Patients were equally categorized into two groups: group I – opioid-free anesthesia (OFA) and group II – OBA. Intraoperative magnesium, total postoperative morphine consumption, time to first postoperative rescue analgesia and adverse effects were recorded.
Results
Total postoperative morphine consumption at 24 h was insignificantly different between groups. The proportion of patients requiring intraoperative magnesium was significantly higher in OBA ( < 0.001). Visual analog scale was only significant at 1 and 2 h which was significantly higher in group OBA than group OFA ( = 0.012 and < 0.001, respectively). Time to first postoperative rescue analgesia was significantly earlier in OBA than in OFA. Hemodynamic stability was insignificantly different between both groups. Bradycardia, postoperative nausea and vomiting and respiratory depression were insignificantly different between groups.
Conclusions
In adolescent patients ASA I-II undergoing scoliosis correction surgery, OFA with a combination of dexmedetomidine, ketamine and lidocaine could provide adequate intra- and postoperative pain management, which can obviate the use of intraoperative opioids minimizing the total postoperative opioid requirements compared to OBA using fentanyl.

DOI

TEJA-2023-0048

Keywords

Scoliosis, Opioid-free anesthesia, opioid-based anesthesia, Analgesia

Authors

First Name

Laila

Last Name

Elahwal

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

First Name

Maram

Last Name

Elmazny

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

First Name

Shimaa Mostafa

Last Name

Elrahwan

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

Volume

39

Article Issue

1

Related Issue

51163

Issue Date

2023-12-01

Receive Date

2023-02-24

Publish Date

2023-12-31

Page Start

650

Page End

656

Print ISSN

1110-1849

Online ISSN

1687-1804

Link

https://egja.journals.ekb.eg/article_387957.html

Detail API

https://egja.journals.ekb.eg/service?article_code=387957

Order

387,957

Publication Type

Journal

Publication Title

Egyptian Journal of Anaesthesia

Publication Link

https://egja.journals.ekb.eg/

MainTitle

The perioperative analgesic effect of opioid free anesthesia using combination of dexmedetomidine, ketamine and lidocaine in adolescent patients undergoing Scoliosis Surgery; A r

Details

Type

Article

Created At

21 Dec 2024