Comparative Study Between the Performance of Opioid Free Anesthesia Versus Conventional Opioid Based Anesthesia Regarding Achievement of Enhanced Recovery in Laparoscopic Bariatric Surgeries
Overview
- Phase
- Not Applicable
- Intervention
- Fentanyl infusion
- Conditions
- Opioid Free Anesthesia
- Sponsor
- Ain Shams University
- Enrollment
- 36
- Primary Endpoint
- Time between the end of analgesic used and an Aldrete score > 9 (when applicable).
- Status
- Not yet recruiting
- Last Updated
- last year
Overview
Brief Summary
This Study aims to evaluate the efficacy of opioid free general anesthesia in achieving enhanced recovery after surgery (ERAS) in laparoscopic bariatric surgery in terms of post-operative recovery time, cumulative pethidine consumption and number of episodes of postoperative nausea and vomiting(PONV).
Detailed Description
While opioids have been commonly used in the operating room due to their effectiveness in pain management and anesthesia, there are numerous common side effects that have an impact on patient recovery. Obese patients or those with pre-existing respiratory difficulties such as sleep apnea or chronic obstructive pulmonary disease are more likely to experience respiratory failure after getting opiate therapy. Other effects of opioid use include gastro-intestinal obstacles such nausea, vomiting, and constipation. The concept of opioid-free anesthesia evolved due to the potential adverse side effects associated with intraoperative opioid usage. This study examines nociceptive monitoring's potential role in opioid-free anesthesia, as well as research on the topic. This study aims to compare the effects of an opioid-free anesthesia (OFA) regimen versus an opioid-based anesthesia (OBA) regimen on postoperative pain and enhanced recovery in patients undergoing bariatric surgery.
Investigators
Eman Mohamed Zain Eldeen
Doctor
Ain Shams University
Eligibility Criteria
Inclusion Criteria
- •Undergoing a scheduled laparoscopic bariatric surgery under general anesthesia.
- •Age group: 18-65 years old.
- •BMI greater than 35 to 50 Kg/m2
- •ASA physical status classes I and II.
Exclusion Criteria
- •Patient refusal.
- •ASA physical status classes III and IV.
- •Anticipated difficult intubation.
- •Hypersensitivity to any drugs used in this study. Inability to extubate the patient at the end of the operation. Conversion to laparotomy. Patients for whom the anesthetic regimen is changed intraoperatively (from OFA to OBA or vice versa).
Arms & Interventions
Fentanyl infusion
Analgesia will be offered by fentanyl in induction and maintenance according to ideal body weight (IBW).
Intervention: Fentanyl infusion
Dexamedomedine and ketamine infusion
Opioid free anesthesia Analgesia will be offered by syringe containing ketamine and dexmedetomidine in induction and maintenance according to IBW.
Intervention: Dexamedomedine and ketamine infusion
Outcomes
Primary Outcomes
Time between the end of analgesic used and an Aldrete score > 9 (when applicable).
Time Frame: 15 minutes
Decrease opioid usage ,decrease recovery time
Time between the end of operation to PACU
Time Frame: 15 minutes
Decrease opioid usage ,decrease recovery time
Secondary Outcomes
- Cumulative pethidine consumption(24 hours postoperative)
- Number of episodes of nausea and vomiting [Time Frame: During the 24 hours following extubation].(24 hours postoperative)