Comparative Study of Conventional Opioid-based Anesthesia and Opioid-sparing Anesthesia in Patients Undergoing Laparoscopic Surgeries.

Abstract

Purpose: Opioid-sparing anesthesia (OSA) is an emerging concept in an attempt to overcome the potential side effects during postoperative recovery associated with opioid-based anesthesia. However, there is a need to assess the extent of pain control and side effects between the two. The objective of the study was to evaluate and compare intraoperative hemodynamic parameters, and postoperative pain control with a secondary objective to determine the postoperative nausea vomiting, and patient satisfaction levels postlaparoscopic surgery.

Methodology: Eighty patients with ASA physical statuses 1 and 2 who were scheduled for laparoscopic procedures, ranging in age from 20 to 70, participated in the study. They were categorized into opioid group (n = 40) and opioid sparing group (n = 40). Participants in the opioid group provided general anesthesia with fentanyl and participants in the opioid-sparing group received general anesthesia without fentanyl but got an infusion after receiving a loading dose of dexmedetomidine. Assessing pain scores and hemodynamic parameters were the primary objective while postoperative nausea and vomiting (PONV) and patient satisfaction were the secondary objective.

Results: The systolic blood pressure and diastolic blood pressure intraoperative hemodynamic parameters were comparable, with the exception of the heart rate, which was considerably greater in the opioid-sparing group at baseline, at 6 h, and 24 h (P = 0.001). Up to 2 h, the opioid-sparing group's visual analog scale scores were considerably lower (P = 0.001), and their patient satisfaction levels were higher (P = 0.01). In both groups, the incidence of PONV was similar.

Conclusion: OSA can be used as an effective alternative to opioid anesthesia.