The Effect of Opioid-Free Anesthesia on the Quality of Recovery After Gynecological Laparoscopy: A Prospective Randomized Controlled Trial

被引：3

作者：

Choi, Hoon ^{[1
]}

Song, Jae Yen ^{[2
]}

Oh, Eun Jee ^{[3
]}

Chae, Min Suk ^{[1
]}

Yu, Sanghyuck ^{[1
]}

Moon, Young Eun ^{[1
,4
]}

机构：

[1] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Anesthesiol & Pain Med, Seoul, South Korea

[2] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Obstet & Gynecol, Seoul, South Korea

[3] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Lab Med, Seoul, South Korea

[4] Catholic Univ Korea, Seoul St Marys Hosp, Coll Med, Dept Anesthesiol & Pain Med, 222Banpo Daero, Seoul 06591, South Korea

来源：

JOURNAL OF PAIN RESEARCH | 2022年 / 15卷

关键词：

opioid-free anesthesia; quality of recovery; laparoscopy; gynecology; opioids; TOTAL INTRAVENOUS ANESTHESIA; POSTOPERATIVE NAUSEA; MATRIX METALLOPROTEINASES; INDUCED HYPERALGESIA; GENERAL-ANESTHESIA; STRESS-RESPONSE; END-POINTS; REMIFENTANIL; SURGERY; PAIN;

D O I：

10.2147/JPR.S373412DovePress

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Purpose: Opioid-free anesthesia (OFA) is an emerging technique that eliminates intraoperative use of opioids and is associated with lower postoperative opioid consumption and reduced adverse postoperative events. The present study investigated the effect of OFA on the quality of recovery in patients undergoing gynecological laparoscopy.Patients and Methods: Seventy-five adult patients undergoing elective gynecological laparoscopy were randomly assigned to the OFA group with dexmedetomidine and lidocaine or the remifentanil-based anesthesia (RA) group with remifentanil. Patients, surgeons, and medical staff members providing postoperative care and assessing outcomes were blinded to group allocation. The anesthesiologist performing general anesthesia could not be blinded due to the different drug administration protocols by groups. The primary outcome was the quality of recovery measured using the Quality of Recovery-40 (QoR-40) questionnaire. Secondary outcomes were postoperative pain score, intraoperative and postoperative adverse events, and stress hormones levels.Results: The patients in both groups had comparable baseline characteristics. The QoR-40 score on postoperative day 1 was significantly higher in the OFA group than in the RA group (155.9 +/- 21.2 in the RA group vs 166.9 +/- 17.8 in the OFA group; mean difference: -11.0, 95% confidence interval: -20.0, -2.0; p = 0.018). The visual analog scale score at 30 min after surgery was significantly lower in the OFA group than in the RA group (6.3 +/- 2.3 in the RA group vs 4.1 +/- 2.1 in the OFA group; p < 0.001). The incidences of nausea and shivering in the post-anesthetic care unit were also significantly lower in the OFA group (p = 0.014 and 0.025; respectively). Epinephrine levels were significantly lower in the OFA group (p = 0.002). Conclusion: OFA significantly improved the quality of recovery in patients undergoing gynecological laparoscopy.

引用

页码：2197 / 2209

页数：13