The effect of opioid-free anesthesia on the post-operative opioid consumption in laparoscopic bariatric surgeries: A randomized controlled double-blind study.

Abstract

This study aimed to evaluate the ability to use opioid-free anesthesia (OFA) technique in morbid obese patients. A prospective randomized double-blinded study. This study was carried out at Tanta University Hospitals (tertiary hospitals). Eighty morbid obese patients scheduled for laparoscopic bariatric surgeries. Patients were allocated randomly into two groups: Group C, in which fentanyl was used during induction and maintenance of anesthesia, and group OFA, in which dexmedetomidine, ketamine, magnesium, and lidocaine were started before the induction of anesthesia and continued throughout the surgery. The post-operative morphine consumption in the first 24 hours (primary outcome) and the intraoperative fentanyl consumption (secondary outcome). In comparison to the control group, OFA technique significantly decreased the post-operative morphine consumption (p = 0.003; 95 percent CI: 0.505; 2.396), shortened the time for the first request of rescue analgesia (p < 0.0001; 95 percent CI: 54.14; 99.11), decreased the post-operative pain score 4 and 6 hours after surgery (p < 0.05), and decreased the post-operative nausea and vomiting (PONV) impact scale (p = 0.022). Furthermore, it significantly decreased the intraoperative fentanyl consumption (p < 0.0001) with the improvement of all parameters of the recovery profile (p < 0.05). OFA in patients undergoing bariatric surgeries significantly decreased the post-operative morphine consumption, the post-operative pain score, the intraoperative fentanyl consumption, and the PONV impact scale with the improvement of the recovery profile.