Comparing opioid free general anesthesia to traditional balanced general anesthesia regarding achievement of enhanced recovery in laparoscopic bariatric surgeries

Abstract

Abstract Background Opioids have historically been a first-line therapy for surgical pain control. They were considered optimum and the mainstay of balanced anesthesia, but recently, concerns about their side effects have been raised. The concept of opioid free anesthesia (OFA) was introduced to provide a safer alternative that would provide benefits as well as enhance recovery after surgery. Results Sixty patients were enrolled in the study, 30 patients in each group. The two groups, TBA and OFA, were comparable in demographic data (age, sex, body mass index (BMI), lean body weight (LBW)) and duration of surgery. The TBA group showed a statistically significant reduction in the time needed for extubation (P value 0.018) and reaching an Aldrete score of 9 (P value 0.02). There was a significant decrease in pain scores, and nalbuphine consumption in the OFA group that extended to 24 h post-operative. Conclusions OFA has a better profile than TBA with regard to post-operative pain score and opioid consumption post-operative, but they have a relative increase in time to extubation and time to reach an Aldrete score of 9.

Keywords

• Opioid-free anesthesia
• Dexmedetomidine
• Ketamine
• Bariatric surgeries