Comparison of opioid-based and opioid-free TIVA for laparoscopic urological procedures in obese patients.
Dexmedetomidine
ketamine
laparoscopic urological procedures
obese patients
propofol
Journal
Journal of anaesthesiology, clinical pharmacology
ISSN: 0970-9185
Titre abrégé: J Anaesthesiol Clin Pharmacol
Pays: India
ID NLM: 9516972
Informations de publication
Date de publication:
Historique:
entrez:
11
1
2020
pubmed:
11
1
2020
medline:
11
1
2020
Statut:
ppublish
Résumé
Perioperative pain management in an obese patient is challenging. The incidence of respiratory depression is higher in obese patients and is exaggerated with opioids. We evaluated the efficacy of opioid-free anesthesia with propofol, dexmedetomidine, lignocaine, and ketamine in obese patients undergoing urological laparoscopic procedures with reference to postoperative analgesic consumption, hemodynamic stability, and respiratory depression. In this prospective, randomized, blinded controlled study, patients were randomized to receive either opioid-based (opioid group) or opioid-free (opioid-free group) anesthesia. Postoperative pain was assessed using visual analog score (VAS) 30 min after recovery, hourly for 2 h and every 4 hourly for 24 h. The primary outcomes studied were respiratory depression, mean analgesic consumption and time to rescue analgesia. Intraoperative hemodynamic parameters, mean SpO There were no differences in the demographic and intraoperative hemodynamic profile between the groups. Incidence of respiratory depression, defined as fall in saturation, was more in opioid-based group. Postoperative analgesic requirement (225 ± 48.4 vs 63.6 ± 68.5 mg of tramadol with Opioid-free anesthesia is a safer and better form of anesthesia in obese patients undergoing laparoscopic urological procedures as there is a lower requirement of postoperative analgesia.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Perioperative pain management in an obese patient is challenging. The incidence of respiratory depression is higher in obese patients and is exaggerated with opioids. We evaluated the efficacy of opioid-free anesthesia with propofol, dexmedetomidine, lignocaine, and ketamine in obese patients undergoing urological laparoscopic procedures with reference to postoperative analgesic consumption, hemodynamic stability, and respiratory depression.
MATERIAL AND METHODS
METHODS
In this prospective, randomized, blinded controlled study, patients were randomized to receive either opioid-based (opioid group) or opioid-free (opioid-free group) anesthesia. Postoperative pain was assessed using visual analog score (VAS) 30 min after recovery, hourly for 2 h and every 4 hourly for 24 h. The primary outcomes studied were respiratory depression, mean analgesic consumption and time to rescue analgesia. Intraoperative hemodynamic parameters, mean SpO
RESULTS
RESULTS
There were no differences in the demographic and intraoperative hemodynamic profile between the groups. Incidence of respiratory depression, defined as fall in saturation, was more in opioid-based group. Postoperative analgesic requirement (225 ± 48.4 vs 63.6 ± 68.5 mg of tramadol with
CONCLUSIONS
CONCLUSIONS
Opioid-free anesthesia is a safer and better form of anesthesia in obese patients undergoing laparoscopic urological procedures as there is a lower requirement of postoperative analgesia.
Identifiants
pubmed: 31920231
doi: 10.4103/joacp.JOACP_382_18
pii: JOACP-35-481
pmc: PMC6939571
doi:
Types de publication
Journal Article
Langues
eng
Pagination
481-486Informations de copyright
Copyright: © 2019 Journal of Anaesthesiology Clinical Pharmacology.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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