Key result
Opioid-free anesthesia significantly increased extubation time (7.5 vs 4.1 minutes, p=0.018) but reduced post-operative pain scores and opioid consumption compared to traditional balanced anesthesia in bariatric surgery.
Why the study?
Concerns have been raised about opioid side effects, prompting the concept of opioid-free anesthesia as a safer alternative to enhance recovery after surgery.
Does opioid free general anesthesia improve recovery outcomes compared to traditional balanced general anesthesia in patients undergoing laparoscopic bariatric surgeries?
RCT (n=60)
Double-blind
Computer generated randomization
No
Does opioid free general anesthesia improve recovery outcomes compared to traditional balanced general anesthesia in patients undergoing laparoscopic bariatric surgeries?
Absolute Event Rate: 7.5% vs 4.1%
p-value: p=0.018
Opioid-free anesthesia reduces post-operative pain and opioid consumption but prolongs extubation and early recovery times compared to traditional balanced anesthesia in bariatric surgery.
May support OFA as an opioid alternative in select cases; leaves open confirmation via larger randomized trials.
Background Opioids have historically been a first-line therapy for surgical pain control. They were considered optimum and the mainstay of balanced anesthesia, but recently, concerns about their side effects have been raised. The concept of opioid free anesthesia (OFA) was introduced to provide a safer alternative that would provide benefits as well as enhance recovery after surgery. Results Sixty patients were enrolled in the study, 30 patients in each group. The two groups, TBA and OFA, were comparable in demographic data (age, sex, body mass index (BMI), lean body weight (LBW)) and duration of surgery. The TBA group showed a statistically significant reduction in the time needed for extubation ( P value 0.018) and reaching an Aldrete score of 9 ( P value 0.02). There was a significant decrease in pain scores, and nalbuphine consumption in the OFA group that extended to 24 h post-operative. Conclusions OFA has a better profile than TBA with regard to post-operative pain score and opioid consumption post-operative, but they have a relative increase in time to extubation and time to reach an Aldrete score of 9.
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Soudi et al. (2022) conducted an RCT in Laparoscopic bariatric surgery (n=60). Opioid-free anesthesia (ketamine and dexmedetomidine) vs. Traditional balanced anesthesia (fentanyl) was evaluated on Extubation time (minutes) (p=0.018). Opioid-free anesthesia significantly increased extubation time (7.5 vs 4.1 minutes, p=0.018) but reduced post-operative pain scores and opioid consumption compared to traditional balanced anesthesia in bariatric surgery.
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