Comparison of opioid and opioid-free anesthesia in bariatric surgery

Abstract

Aim: Opioids are widely used in anesthesia. Postoperative nausea and vomiting (PONV) is known to have side effects such as tremors and urinary retention and so on. Several studies have been conducted in recent years indicating that multimodal analgesia reduces opioid consumption. There are very few studies comparing opioid-free anesthesia with Laparoscopic Sleeve Gastrectomy (LSG). The aim of this study is to evaluate the effects of opioid-free anesthesia on pain scores and healing process in patients with LSG surgery.Material and Method: This study was conducted on 64 cases between the ages of 18-65 prospectively in the general surgical operating room of Pamukkale University Hospital. Patients were randomly selected and grouped according to anesthesia method at the beginning of the surgery. Remifentanil as an opioid was administered for analgesia in Group I. Iv paracetamol, ibuprofen, ketamine and magnesium sulfate were administered in Group II. NRS was used as a pain score. Patients included in the study were followed from the beginning of the operation to the end of the postoperative 24 hours. The obtained data were analyzed using the SPSS 25 software.Results: The body mass index (BMI) of the patients included in the study was 40 and above. In the study, women in both groups were in the majority (>= 75%). In both groups, cesarean section was in the majority of patients in the history of a previous surgery. Patients in Group I were significantly higher when hypotension was examined. There was no significant difference in SpO(2)<94%, obstructive respiration, nausea, vomiting, chills, tramadol use, antiemetic need and mean TOF values in postoperative recovery unit. There was no significant difference in NRS score between groups at postoperative 1, 6, 12 and 24 hours. There were partially more complications in postoperative Group I.Discussion: There was no significant difference between non-opioid anesthesia and opioid anesthesia, but the non-opioid anesthesia protocol can be safely used in LSG.