Opioid-free Anesthesia for Laparoscopic Gastroplasty. A Prospective and Randomized Trial

Abstract

Background: Opioid-free anesthesia (OFA) has gained popularity in recent years due to concerns about the abusive use of this drug but also due to the potential benefits of OFA for pain control and decreased side effects. Objectives: This trial aimed to study whether opioid-free anesthesia (OFA) benefits patients submitted to laparoscopic gastroplasty compared to anesthesia with fentanyl. The primary objective was to measure pain score and morphine use for rescue analgesia. The secondary objective was to evaluate the incidence of postoperative nausea and vomiting (PONV) and oxygen desaturation. Methods: Patients undergoing gastroplasty were randomized to receive general anesthesia with fentanyl (n = 30) or OFA (n = 30) according to a predefined protocol. They were assessed for pain using a verbal numerical scale (VNS), morphine consumption and PONV in the post-anesthesia care unit and on the first day after surgery. Besides, oxygen desaturation during the immediate postoperative period was also recorded. The study was blinded to the surgeon and postoperative evaluators. Results: The groups were comparable for all demographic data analyzed. A significance level of 5% was used, and no differences were found in the variables studied. Conclusion: The specific OFA protocol presented in this trial was safe and effective. However, this study did not find any benefit in using it compared with fentanyl anesthesia in videolaparoscopic gastroplasties.