Comparation Among Opioid-Based, Low Opioid and Opioid Free Anesthesia in Colorectal Oncologic Surgery

Area of Science:

• Anesthesiology
• Surgical Pain Management
• Oncology

Background:

• Opioids are standard for surgical pain but may impair immunity and promote cancer recurrence.
• Multimodal analgesia, including opioid-free anesthesia (OFA), offers an alternative for pain management.
• OFA avoids intraoperative opioids, potentially improving patient outcomes.

Purpose of the Study:

• To compare the efficacy of opioid-free anesthesia (OFA) versus opioid-based anesthesia (OBA) and low-opioid anesthesia (LOA) in managing postoperative pain.
• To evaluate secondary outcomes including postoperative nausea and vomiting (PONV), rescue analgesia requirements, and intraoperative medication usage.

Main Methods:

• A prospective, randomized clinical study involving 60 patients undergoing open colorectal surgery.
• Patients were divided into three groups: OBA, LOA, and OFA, each receiving different anesthetic and analgesic protocols.
• Pain was assessed using the Visual Analogue Scale (VAS) at multiple time points up to 72 hours post-surgery.

Main Results:

• OFA group demonstrated significantly lower VAS pain scores at 2, 12, 24, and 48 hours post-surgery compared to OBA and LOA groups.
• The OFA group required less postoperative morphine and rescue analgesia and reported no PONV.
• OFA patients received less intraoperative bupivacaine compared to the OBA group.

Conclusions:

• Opioid-free anesthesia is effective in reducing postoperative pain and PONV after colorectal surgery.
• OFA offers a superior pain management strategy compared to traditional opioid-based or low-opioid approaches.
• OFA may be a valuable component of enhanced recovery after surgery protocols.