Opioid-free versus opioid-based anesthesia in pancreatic surgery

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Stéphane Hublet1, Marianne Galland1, Julie Navez2

  • 1Department of Anesthesiology, Université Libre de Bruxelles, CUB Érasme, Brussels, Belgium.

BMC Anesthesiology
|January 5, 2022
PubMed
Abstract

Insights

Opioid-free anesthesia (OFA) significantly reduces pain and opioid consumption after pancreatic surgery compared to opioid-based anesthesia (OBA). OFA also shortens hospital stays and lowers complication rates, suggesting improved patient outcomes.

Area of Science:

  • Anesthesiology
  • Surgical Outcomes
  • Pain Management

Background:

  • Opioid-free anesthesia (OFA) is known to reduce postoperative opioid use.
  • Its feasibility and impact on outcomes in pancreatic surgery remain under investigation.

Purpose of the Study:

  • To evaluate the efficacy and safety of OFA compared to opioid-based anesthesia (OBA) in patients undergoing pancreatic resection.
  • To assess the impact of OFA on postoperative pain, opioid consumption, length of stay, and complications.

Main Methods:

  • Retrospective review of 77 patients undergoing pancreatic resection, divided into OBA (n=42) and OFA (n=35) groups.
  • OFA involved continuous infusions of dexmedetomidine, lidocaine, and esketamine.
  • OBA included intraoperative remifentanil and intrathecal morphine.

Main Results:

  • OFA group showed significantly lower pain scores (NRS) and opioid consumption post-extubation.
  • Patients receiving OFA experienced a shorter length of hospital stay by 4 days.
  • The comprehensive complication index (CCI) was significantly lower in the OFA group.

Conclusions:

  • Opioid-free anesthesia is feasible for pancreatic resection and associated with better pain outcomes.
  • OFA may lead to improved patient outcomes and reduced hospital stays, warranting further randomized trials.
Keywords:
Analgesics, Non-Narcotic / therapeutic useAnalgesics, Opioid / therapeutic useBalanced Anesthesia / methodsPain, Postoperative / drug therapyTreatment Outcome

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