Applying Opioid Free Anesthesia (Ofa) In Combination with Enhanced Recovery Anesthesia (Eras) In Bariatric-Metabolic Surgery: Evaluation at One Year Follow-Up with A Propensity Score

Abstract

Since its introduction, laparoscopic bariatric metabolic surgery (BMS) has witnessed a consistant decrease in complications. Recently, enhanced recovery after surgery (ERAS) and opioid free (OFA) protocols have been developed separately to further improve outcomes. To assess the surgical outcomes after ERAS in combination with OFA (ERAS+OFA) in BMS. High volume bariatric metabolic center in Belgium. A retrospective observational study comparing by propensity score matching the outcomes of our center (ERAS+OFA) with the outcomes of an Italian center of excellence adhering to opioid sparing, but not opioid free ERAS (ERAS-OFA). Primary endpoints were: length of hospital stay, number of readmissions and complications including leaks and bleedings. Secondary endpoints were: the number and severity of complications as evaluated by the Clavien-Dindo score. Over a 12-month period, 341 consecutive patients treated according to ERAS+OFA in our center, were compared to 109 according to ERAS-OFA in the Italian center. Propensity matching resulted in comparable groups. Primary and secondary endpoints showed no significant difference between the 2 groups. Our study shows no statistically significant difference in BMS outcomes between ERAS+OFA compared to ERAS- OFA