Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial.

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

BMC Anesthesiology Pub Date : 2025-02-08 DOI:10.1186/s12871-025-02938-x

Xiang Yan, Chen Liang, Jia Jiang, Ying Ji, An-Shi Wu, Chang-Wei Wei

{"title":"Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial.","authors":"Xiang Yan, Chen Liang, Jia Jiang, Ying Ji, An-Shi Wu, Chang-Wei Wei","doi":"10.1186/s12871-025-02938-x","DOIUrl":null,"url":null,"abstract":"Objectives: Postoperative nausea and vomiting (PONV) is common after video-assisted thoracic surgery, which may be associated with the use of intraoperative opioids. We tested the hypothesis that balanced opioid-free anesthesia (OFA) might reduce the incidence of PONV after video-assisted thoracic surgery.Methods: One hundred and sixty-eight adults undergoing video-assisted thoracic assisted surgery were randomly assigned to receive balanced opioid-free anesthesia or balanced opioid-based anesthesia (OBA). The primary outcome was the incidence of PONV, which was assessed with the Myles's simplified PONV impact scale during the initial 24 h after surgery.Results: Compared with OBA group, the overall incidence of PONV in OFA group was significant reduced (14.6% vs. 30.1%, P = 0.017), and OFA reduced the risk of PONV events within 24 h of surgery (HR, 0.44; 95%CI: 0.22-0.87, P = 0.018). The incidence of other postoperative complications in OFA group was lower than that in OBA group (19.5% vs. 33.7%, P = 0.039). The quality of recovery, distance of 6-minute walk test, pain scores, and 36-item short form survey were comparable at each time points.Conclusion: In patients undergoing video-assisted thoracic surgery, the use of balanced OFA anesthesia can help reduce the incidence of PONV events. This anesthetic regimen has shown good feasibility without significantly increasing the patient's pain score and complications.Clinical trial registration number: Clinicaltrials.gov, Identifier: NCT05411159. First posted date: 9 Jun, 2022.","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"62"},"PeriodicalIF":2.3000,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806895/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Anesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12871-025-02938-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: Postoperative nausea and vomiting (PONV) is common after video-assisted thoracic surgery, which may be associated with the use of intraoperative opioids. We tested the hypothesis that balanced opioid-free anesthesia (OFA) might reduce the incidence of PONV after video-assisted thoracic surgery.

Methods: One hundred and sixty-eight adults undergoing video-assisted thoracic assisted surgery were randomly assigned to receive balanced opioid-free anesthesia or balanced opioid-based anesthesia (OBA). The primary outcome was the incidence of PONV, which was assessed with the Myles's simplified PONV impact scale during the initial 24 h after surgery.

Results: Compared with OBA group, the overall incidence of PONV in OFA group was significant reduced (14.6% vs. 30.1%, P = 0.017), and OFA reduced the risk of PONV events within 24 h of surgery (HR, 0.44; 95%CI: 0.22-0.87, P = 0.018). The incidence of other postoperative complications in OFA group was lower than that in OBA group (19.5% vs. 33.7%, P = 0.039). The quality of recovery, distance of 6-minute walk test, pain scores, and 36-item short form survey were comparable at each time points.

Conclusion: In patients undergoing video-assisted thoracic surgery, the use of balanced OFA anesthesia can help reduce the incidence of PONV events. This anesthetic regimen has shown good feasibility without significantly increasing the patient's pain score and complications.

Clinical trial registration number: Clinicaltrials.gov, Identifier: NCT05411159. First posted date: 9 Jun, 2022.

查看原文本刊更多论文

平衡无阿片类药物麻醉对电视胸外科手术患者术后恶心和呕吐的影响：一项随机试验

目的：术后恶心呕吐（PONV）在胸外科手术后很常见，这可能与术中阿片类药物的使用有关。我们验证了平衡无阿片类药物麻醉（OFA）可能降低胸腔镜手术后PONV发生率的假设。方法：168名接受胸腔镜辅助手术的成人随机分为平衡无阿片类药物麻醉和平衡阿片类药物麻醉（OBA）两组。主要观察指标是PONV的发生率，在术后最初24小时内用Myles简化PONV影响量表进行评估。结果：与OBA组相比，OFA组PONV总发生率显著降低（14.6% vs. 30.1%, P = 0.017），且OFA降低了手术后24 h内PONV事件的发生风险(HR, 0.44；95%ci: 0.22-0.87, p = 0.018)。OFA组术后其他并发症发生率低于OBA组（19.5% vs. 33.7%, P = 0.039）。恢复质量、6分钟步行距离测试、疼痛评分和36项简短问卷调查在每个时间点具有可比性。结论：在接受胸腔镜手术的患者中，使用平衡OFA麻醉有助于减少PONV事件的发生。这种麻醉方案已显示出良好的可行性，不会显著增加患者的疼痛评分和并发症。临床试验注册号：Clinicaltrials.gov，标识符：NCT05411159。首次发布日期：2022年6月9日。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMC Anesthesiology ANESTHESIOLOGY-

CiteScore

3.50

自引率

4.50%

发文量

349

审稿时长

>12 weeks

期刊介绍： BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.