Opioid-free anaesthesia for laparoscopic surgeries - A prospective non-randomised study in a tertiary care hospital

Abstract

Background and aims: Opioids have nowadays become superfluous because of their adverse effects involving post-operative recovery of the patients. So, we aimed at comparing opioid-free anaesthesia with opioid-based technique for post-operative pain relief in laparoscopic surgeries. The primary objective was to assess the pain scores in the post-operative period using visual analogue scale (VAS) for 24 h, and the secondary objective was to compare intraoperative haemodynamic parameters, duration of postoperative analgesia and total analgesics consumed in the first 24 h.

Methods: This study was conducted in 60 patients aged between 20 and 70 years, belonging to the American Society of Anesthesiologists physical class I and II posted for laparoscopic surgeries. Anaesthetic doses of lidocaine, magnesium and paracetamol in combination with fascial plane block for post-operative pain relief were given for 30 patients, and the other 30 patients received the conventional opioid-based anaesthesia. Mann-Whitney test was used for VAS scores, and Friedman test was used for repeated measures comparison.

Results: VAS scores were higher in the conventional group as compared to the opioid-free group at 0, 2, 4, and 6 h during rest and at 0, 2, 4, 6, 24 h during movement and were statistically significant (P-value < 0.05). The duration of analgesia for the conventional group was 13.8 + 6.7 h, and for opioid-free anaesthesia was 6.7 + 2.2 hours. Intraoperative haemodynamic parameters did not show a statistically significant difference except for systolic blood pressure which was higher in the opioid-free group but was clinically insignificant. (P-value 0.013).

Conclusion: Opioid-free anaesthesia along with erector spinae plane block provides better post-operative pain relief when compared to conventional opioid anaesthesia.

Keywords: Block; magnesium; opioid; postoperative pain.

Conflict of interest statement

There are no conflicts of interest.

Copyright: © 2022 Indian Journal of Anaesthesia.

Figures

Figure 1

Image showing erector spinae plane with transducer placed in a parasagittal orientation and local anaesthetic is seen deposited underneath the erector spinae muscle. [ESM = Erector spinae muscle, LA = Local anaesthetic, TP = Transverse process]