General Anesthetic, Ketamine, Obesity &Amp; Overweight
Conditions
Keywords
obesity, general anesthesia, ketamine
Brief summary
The study aimed to compare balanced anesthesia protocols using only opioids as analgesics during induction in gastric sleeve surgery with protocols using opioids and ketamine together in terms of anesthesia management, opioid side effects, and postoperative analgesia.
Detailed description
During gastric sleeve surgery under general anesthesia, various drugs are administered intraoperatively to induce loss of consciousness, immobility, and pain relief (analgesia). Opioids are the most commonly used analgesics. However, the response to opioids varies widely, and their use is associated with significant side effects. In balanced general anesthesia, in addition to opioid medications, hypnotics, NMDA antagonists (ketamine, magnesium sulfate), sodium channel blockers (local anesthetics), anti-inflammatory drugs (NSAIDs, dexamethasone), and alpha-2 agonists (dexmedetomidine, clonidine) may be used. One of the components of ERAS (Enhanced Recovery After Surgery) protocols, which aim to reduce metabolic stress developing in response to surgery and promote rapid recovery after surgery, is to provide effective postoperative analgesia while using opioids as little as possible. These different anesthesia approaches may offer options for surgery. The addition of ketamine to anesthesia induction and maintenance may affect postoperative opioid consumption. Adding ketamine to anesthesia induction and maintenance may affect postoperative opioid consumption. Reducing opioid consumption can prevent opioid-related side effects such as nausea, constipation, and itching. Opioid-related side effects such as nausea, constipation, and itching can be prevented by reducing opioid consumption.
Interventions
None listed
Sponsors
Balikesir University
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Patients who have undergone gastric sleeve surgery Patients with mild systemic disease Patients with severe systemic disease that does not affect daily activities
Exclusion criteria
Those with data loss in their files Those who do not use patient-controlled analgesia devices Patients who did not undergo standard anesthesia protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Morphine Equivalent Opioid Consumption | 24 hours | A comparison was made based on the equivalent doses of opioid analgesic drugs used in both groups relative to morphine. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain | 24 hours | Postoperative pain is assessed using a numerical pain scale. The Numerical Pain Rating Scale (NRS) was used in the study. NRS pain scores range from 0 (no pain) to 10 (most severe pain) |
Countries
Turkey (Türkiye)
Participant flow
Recruitment details
96 Number of study patients
Pre-assignment details
Of the patient records evaluated for compliance (n=205), 109 did not comply with standard protocols or had incomplete data as follows: 55 patients did not receive patient-controlled analgesia for postoperative pain management, 15 patients did not receive intravenous lidocaine (1.5 mg/kg ideal body weight), 33 patients did not receive intravenous fentanyl (1.0 µg/kg total body weight), and 6 patients lacked records of postoperative analgesic administration.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 96 Participants |
| Race and Ethnicity Not Collected | 0 Participants |
| Region of Enrollment Turkey | 47 Participants |
| Sex: Female, Male Female | 32 Participants |
| Sex: Female, Male Male | 15 Participants |
| weight | 126 kg STANDARD_DEVIATION 21.64 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 49 | 0 / 47 |
| other Total, other adverse events | 0 / 49 | 0 / 47 |
| serious Total, serious adverse events | 0 / 49 | 0 / 47 |
Outcome results
None listed