BMC Anesthesiol: Comparison of non-opioid and opioid anesthesia in pancreatic surgery

background

background background

Compared with opioid anesthesia (OBA), non-opioid anesthesia (OFA) can significantly reduce the total postoperative morphine use; however, whether OFA is feasible and whether it may improve the prognosis of pancreatic surgery patients remains unclear
.

Non-opioid anesthesia (OFA) significantly reduces total postoperative morphine use compared with opioid anesthesia (OBA); however, whether OFA is feasible and may improve outcomes in pancreatic surgery remains unclear

method

method method

The perioperative data of 77 patients undergoing pancreatectomy were retrospectively analyzed, receiving OBA combined with remifentanil (n=42) or OFA (n=35).
OFA group included continuous infusion of dexmedetomidine, lido Caine and esketamine
.

In the OBA group, patients also received a single intrathecal injection of morphine, and all patients received a combination of propofol, sevoflurane, dexamethasone, diclofenac sodium, and muscle relaxants intraoperatively

All patients were treated with propofol, sevoflurane, dexamethasone, diclofenac sodium and muscle relaxants

result result

Compared with OBA group, OFA group had NRS score (3[2-4] vs 0[0-2], p<0.
001) and opioid use (36[24-52] vs 10[2-24], p<0.
001) p=0.
005) were significantly reduced; the length of hospital stay in the OFA group was shortened by 4 days (14[7-46] vs 10[6-16], p<0.
001); postoperative pancreatic fistula (p=0.
0002) and delayed gastric emptying ( p<0.
0001) was an independent factor affecting the length of hospital stay; the OFA group had a lower composite complication index (CCI) (24.
9±25.
5vs14.
1±23.
4, p=0.
03)
.

There were no significant differences between the two groups in demographics, operative time, blood loss, bradycardia, application of vasoactive drugs, and extubation time

There were no significant differences in demographics, operative time, blood loss, bradycardia, use of vasoactive drugs, or duration of extubation

in conclusion

conclusion conclusion

In this sequence study, OFA was feasible in pancreatectomy and had a better prognosis, reducing postoperative pain scores
.

The lower postoperative complication rate may inform future randomized trials and test the hypothesis that OFA improves patient outcomes and shortens hospital stays

In this sequence study, OFA was feasible in pancreatectomy and had a better prognosis, reducing postoperative pain scores

Original source:

Original source:

Hublet S, Galland M, Navez J, et al.

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