Efficacy of Opioid-Free Anesthesia with Dexmedetomidine in Inhibiting Nociception during Laparoscopic Abdominal Procedures: A Randomized Clinical Trial

Background: Opioid anesthesia (OA) effectively suppresses surgical stress but has significant limitations, leading to the exploration of opioid-free anesthesia (OFA) with dexmedetomidine to avoid opioid-related side effects. This study aimed to assess the efficacy of OFA with dexmedetomidine in cont...

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Main Authors: Anisa Olata, Susilo Chandra, Arif H. M. Marsaban, Aida Rosita Tantri
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Bali Journal of Anesthesiology
Subjects:
Online Access:https://doi.org/10.4103/bjoa.bjoa_199_24
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author Anisa Olata
Susilo Chandra
Arif H. M. Marsaban
Aida Rosita Tantri
author_facet Anisa Olata
Susilo Chandra
Arif H. M. Marsaban
Aida Rosita Tantri
author_sort Anisa Olata
collection DOAJ
description Background: Opioid anesthesia (OA) effectively suppresses surgical stress but has significant limitations, leading to the exploration of opioid-free anesthesia (OFA) with dexmedetomidine to avoid opioid-related side effects. This study aimed to assess the efficacy of OFA with dexmedetomidine in controlling intraoperative nociception during laparoscopic abdominal surgery. Materials and Methods: A total of 58 subjects undergoing abdominal laparoscopic surgery were enrolled in the study and were randomly assigned into two groups: the OFA group (n = 29) received a dexmedetomidine bolus of 1 µg/kg, and the OA group (n = 29) received a fentanyl bolus of 2 µg/kg. Both groups received standard balanced anesthesia. Hemodynamic instability events (hypotension, bradycardia, hypertension, and tachycardia), intraoperative fentanyl rescue requirement, ephedrine consumption, and 1-h postoperative pain numeric rating scale (NRS) were documented and analyzed. Results: The two groups showed significant differences in intraoperative rescue fentanyl requirement (2 vs. 29, P < 0.001) with the amount of fentanyl dosages (50 vs 150 µg, P = 0.004), the median post-intubation qNox value (44.1 ± 5.4 vs. 49 ± 9.8, P = 0.002), and NRS scale 1 h post-surgery (1 vs. 2, P = 0.001). There was no significant difference in the number of incidences of intraoperative hypotension, hypertension, bradycardia, and tachycardia incidence between the two groups. Conclusion: OFA with dexmedetomidine is more effective than OA in inhibiting intraoperative nociception during laparoscopic abdominal surgery as it reduces the rescue fentanyl requirement while providing stable intraoperative hemodynamics.
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spelling doaj-art-f31b33ebfccc4b97b89d5782f679847f2025-01-17T10:42:56ZengWolters Kluwer Medknow PublicationsBali Journal of Anesthesiology2549-22762024-12-018422723310.4103/bjoa.bjoa_199_24Efficacy of Opioid-Free Anesthesia with Dexmedetomidine in Inhibiting Nociception during Laparoscopic Abdominal Procedures: A Randomized Clinical TrialAnisa OlataSusilo ChandraArif H. M. MarsabanAida Rosita TantriBackground: Opioid anesthesia (OA) effectively suppresses surgical stress but has significant limitations, leading to the exploration of opioid-free anesthesia (OFA) with dexmedetomidine to avoid opioid-related side effects. This study aimed to assess the efficacy of OFA with dexmedetomidine in controlling intraoperative nociception during laparoscopic abdominal surgery. Materials and Methods: A total of 58 subjects undergoing abdominal laparoscopic surgery were enrolled in the study and were randomly assigned into two groups: the OFA group (n = 29) received a dexmedetomidine bolus of 1 µg/kg, and the OA group (n = 29) received a fentanyl bolus of 2 µg/kg. Both groups received standard balanced anesthesia. Hemodynamic instability events (hypotension, bradycardia, hypertension, and tachycardia), intraoperative fentanyl rescue requirement, ephedrine consumption, and 1-h postoperative pain numeric rating scale (NRS) were documented and analyzed. Results: The two groups showed significant differences in intraoperative rescue fentanyl requirement (2 vs. 29, P < 0.001) with the amount of fentanyl dosages (50 vs 150 µg, P = 0.004), the median post-intubation qNox value (44.1 ± 5.4 vs. 49 ± 9.8, P = 0.002), and NRS scale 1 h post-surgery (1 vs. 2, P = 0.001). There was no significant difference in the number of incidences of intraoperative hypotension, hypertension, bradycardia, and tachycardia incidence between the two groups. Conclusion: OFA with dexmedetomidine is more effective than OA in inhibiting intraoperative nociception during laparoscopic abdominal surgery as it reduces the rescue fentanyl requirement while providing stable intraoperative hemodynamics.https://doi.org/10.4103/bjoa.bjoa_199_24dexmedetomidinehemodynamic instabilitylaparoscopic abdominal surgerynociceptionopioid-free anesthesia
spellingShingle Anisa Olata
Susilo Chandra
Arif H. M. Marsaban
Aida Rosita Tantri
Efficacy of Opioid-Free Anesthesia with Dexmedetomidine in Inhibiting Nociception during Laparoscopic Abdominal Procedures: A Randomized Clinical Trial
Bali Journal of Anesthesiology
dexmedetomidine
hemodynamic instability
laparoscopic abdominal surgery
nociception
opioid-free anesthesia
title Efficacy of Opioid-Free Anesthesia with Dexmedetomidine in Inhibiting Nociception during Laparoscopic Abdominal Procedures: A Randomized Clinical Trial
title_full Efficacy of Opioid-Free Anesthesia with Dexmedetomidine in Inhibiting Nociception during Laparoscopic Abdominal Procedures: A Randomized Clinical Trial
title_fullStr Efficacy of Opioid-Free Anesthesia with Dexmedetomidine in Inhibiting Nociception during Laparoscopic Abdominal Procedures: A Randomized Clinical Trial
title_full_unstemmed Efficacy of Opioid-Free Anesthesia with Dexmedetomidine in Inhibiting Nociception during Laparoscopic Abdominal Procedures: A Randomized Clinical Trial
title_short Efficacy of Opioid-Free Anesthesia with Dexmedetomidine in Inhibiting Nociception during Laparoscopic Abdominal Procedures: A Randomized Clinical Trial
title_sort efficacy of opioid free anesthesia with dexmedetomidine in inhibiting nociception during laparoscopic abdominal procedures a randomized clinical trial
topic dexmedetomidine
hemodynamic instability
laparoscopic abdominal surgery
nociception
opioid-free anesthesia
url https://doi.org/10.4103/bjoa.bjoa_199_24
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