Opioid Free Anesthesia, Laparoscopic Bariatric Surgeries
Conditions
Keywords
Opioid free anesthesia, laparoscopic bariatric surgeries
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.
Interventions
opioid based anesthesia analgesia will be offered by fentanyl in induction and maintenance according to Ideal Body Weight (IBW).
DRUGDexamedomedine and ketamine infusion
Analgesia will be offered by syringe containing ketamine and Dexmedetomidine in induction and maintenance according to IBW.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
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).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time between the end of analgesic used and an Aldrete score > 9 (when applicable). | 15 minutes | Decrease opioid usage ,decrease recovery time |
| Time between the end of operation to PACU | 15 minutes | Decrease opioid usage ,decrease recovery time |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cumulative pethidine consumption | 24 hours postoperative | decrease the need to postoperative pethidine |
| Number of episodes of nausea and vomiting [Time Frame: During the 24 hours following extubation]. | 24 hours postoperative | number of episodes of nausea and vomiting postoperative |
Contacts
Primary ContactEman Mohamed Zain
Backup ContactEman Zain
Outcome results
None listed