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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Wolters Kluwer Medknow Publications
2024-12-01
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Series: | Bali Journal of Anesthesiology |
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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. |
format | Article |
id | doaj-art-f31b33ebfccc4b97b89d5782f679847f |
institution | Kabale University |
issn | 2549-2276 |
language | English |
publishDate | 2024-12-01 |
publisher | Wolters Kluwer Medknow Publications |
record_format | Article |
series | Bali Journal of Anesthesiology |
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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