Key result
Low-opioid anesthesia during laparoscopic hysterectomy provided greater stabilization of heart rate variability, significantly lowering the LF/HF ratio by 26.1% compared to standard opioid anesthesia and by 60.6% compared to opioid-free anesthesia.
Why the study?
To evaluate the effectiveness of different anesthesia options for laparoscopic hysterectomy, including low-opioid and opioid-free anesthesia, by studying heart rate variability indicators.
Does low-opioid or opioid-free anesthesia improve heart rate variability stability compared to standard opioid anesthesia in women undergoing laparoscopic hysterectomy?
RCT (n=102)
Randomly assigned
No
Does low-opioid or opioid-free anesthesia improve heart rate variability stability compared to standard opioid anesthesia in women undergoing laparoscopic hysterectomy?
Effect estimate: lower by 26.1% vs standard opioid anesthesia and 60.6% vs opioid-free anesthesia
p-value: p=0.042 vs standard opioid anesthesia; 0.033 vs opioid-free anesthesia
Low-opioid anesthesia provides better autonomic nervous system stability and stress protection during laparoscopic hysterectomy compared to standard or opioid-free anesthesia.
Low-opioid anesthesia improves autonomic stability in laparoscopic hysterectomy; extends RCT evidence for opioid-sparing techniques.
The objective: was to evaluate the effectiveness of various anesthesia options for laparoscopic hysterectomy, including low-opioid (LOA) and opioid-free anesthesia (OFA) by studying the dynamics of heart rate variability (HRV) indicators.Materials and methods. 102 patients were randomly assigned to 3 groups: 37 patients who received standard opioid anesthesia (control group), 33 women who received the LOA group, and 32 patients who received OFA.Results. Laparoscopic hysterectomy is accompanied by tension of the autonomic nervous system, especially its sympathetic link, which is manifested by an increase in the index of vago-sympathetic interaction at the traumatic stage of the operation. These changes were most significant in patients who received standard and opioid-free anesthesia, which indirectly indicates insufficient stress protection of these types of intraoperative anesthesia.Conclusions. The use of low-opioid anesthesia is accompanied by a greater stabilization of HRV indices, which indicates its sufficient autonomic protection during laparoscopic hysterectomy than standard and opioid-free anesthesia.
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Zaychenko et al. (2021) conducted an RCT in Laparoscopic hysterectomy (n=102). Low-opioid anesthesia (LOA) vs. Standard opioid anesthesia (control) and opioid-free anesthesia (OFA) was evaluated on Index of vago-sympathetic interaction (LF/HF ratio) at the traumatic stage of the operation (lower by 26.1% vs standard opioid anesthesia and 60.6% vs opioid-free anesthesia, p=0.042 vs standard opioid anesthesia; 0.033 vs opioid-free anesthesia). Low-opioid anesthesia during laparoscopic hysterectomy provided greater stabilization of heart rate variability, significantly lowering the LF/HF ratio by 26.1% compared to standard opioid anesthesia and by 60.6% compared to opioid-free anesthesia.
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