Key result
Opioid-free anesthesia resulted in similar Quality of Recovery-15 scores at 24 hours postoperatively compared to opioid-sparing anesthesia in patients undergoing VATS (124.2 vs 123.0, p=0.227).
Why the study?
With growing concerns about opioid-related risks, perioperative opioid-reduction strategies have increased, but postoperative recovery outcomes comparing opioid-free and opioid-sparing anesthesia under multimodal analgesia in VATS were not established.
Does dexmedetomidine-based opioid-free anesthesia improve postoperative recovery compared to remifentanil-based opioid-sparing anesthesia in patients undergoing video-assisted thoracoscopic surgery?
Cohort (n=196)
Does dexmedetomidine-based opioid-free anesthesia improve postoperative recovery compared to remifentanil-based opioid-sparing anesthesia in patients undergoing video-assisted thoracoscopic surgery?
Absolute Event Rate: 124.2% vs 123%
p-value: p=0.227
Dexmedetomidine-based opioid-free anesthesia and remifentanil-based opioid-sparing anesthesia provide comparable postoperative recovery in patients undergoing video-assisted thoracoscopic surgery.
Similar recovery with OFA versus OSA in VATS; leaves open advantages in other settings or protocols.
Background: With growing concerns about opioid-related risks, efforts to reduce opioid use throughout the perioperative period have increased. This study aimed to compare postoperative recovery outcomes between opioid-free anesthesia (OFA) and opioid-sparing anesthesia (OSA) under a multimodal analgesic protocol in video-assisted thoracoscopic surgery (VATS). Methods: A retrospective cohort study was conducted on 196 patients undergoing VATS from August 2019 to December 2021. Patients received either dexmedetomidine-based OFA or remifentanil-based OSA. Postoperative recovery was assessed using the Quality of Recovery-15 (QoR-15) score, opioid consumption, and pain intensity. Additionally, opioid-related complications and intraoperative hemodynamic changes were evaluated. Results: Both groups showed similar QoR-15 scores 24 h postoperatively (124.2 ± 7.0 vs. 123.0 ± 6.9, p = 0.227). Opioid consumption and pain intensity were comparable, and the incidence of opioid-related adverse events did not significantly differ between the groups. Intraoperative hypotension and bradycardia were more frequent in the OFA group, but the differences were not statistically significant. Conclusions: The study concluded that both OFA and OSA, when used under a multimodal analgesic protocol, provided effective postoperative recovery in patients undergoing VATS with no significant differences in outcomes.
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Kim et al. (2024) conducted a cohort in Video-assisted thoracoscopic surgery (VATS) (n=196). Dexmedetomidine-based opioid-free anesthesia (OFA) vs. Remifentanil-based opioid-sparing anesthesia (OSA) was evaluated on Quality of Recovery-15 (QoR-15) score 24 h postoperatively (p=0.227). Opioid-free anesthesia resulted in similar Quality of Recovery-15 scores at 24 hours postoperatively compared to opioid-sparing anesthesia in patients undergoing VATS (124.2 vs 123.0, p=0.227).
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