Esketamine opioid-free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video-assisted thoracic surgery: a randomized controlled trial
BackgroundOpioid-free anesthesia (OFA) provides adequate analgesia and can reduce postoperative opioid consumption, but its efficacy in spontaneous ventilation video-assisted thoracic surgery (SV-VATS) has not been demonstrated. We aimed to investigate the hypothesis that OFA could provide the same...
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| Format: | Article |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1145953/full |
| _version_ | 1827936885433958400 |
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| author | Qisen Fan Jinhui Luo Qianling Zhou Yaoliang Zhang Xin Zhang Jiayang Li Long Jiang Lan Lan |
| author_facet | Qisen Fan Jinhui Luo Qianling Zhou Yaoliang Zhang Xin Zhang Jiayang Li Long Jiang Lan Lan |
| author_sort | Qisen Fan |
| collection | DOAJ |
| description | BackgroundOpioid-free anesthesia (OFA) provides adequate analgesia and can reduce postoperative opioid consumption, but its efficacy in spontaneous ventilation video-assisted thoracic surgery (SV-VATS) has not been demonstrated. We aimed to investigate the hypothesis that OFA could provide the same perioperative pain control as opioid anesthesia (OA), maintain safe and stable respiration and hemodynamics during surgery, and improve postoperative recovery.MethodsSixty eligible patients (OFA group: n=30; OA group: n=30) treated between September 15, 2022, and December 15, 2022, at The First Hospital of Guangzhou Medical University were included. They were randomized to receive standard balanced OFA with esketamine or OA with remifentanil combined with sufentanil. The primary outcome was the pain numeric rating score (NRS) at postoperative 24 h, and the secondary outcomes were intraoperative respiratory and hemodynamic data, opioid consumption, vasoactive drug dosage, and recovery in the post-anesthesia care unit and ward.ResultsThere was no significant difference in the postoperative pain scores and recovery quality between the two groups. The OFA group had a significantly lower dose of phenylephrine (P=0.001) and a lower incidence of hypotension (P=0.004) during surgery. The OFA group resumed spontaneous respiration faster (P<0.001) and had a higher quality of lung collapse (P=0.02). However, the total doses of propofol and dexmetomidine were higher (P=0.03 and P=0.02), and the time to consciousness was longer (P=0.039) in the OFA group.ConclusionsOFA provides the same level of postoperative pain control as OA, but it is more advantageous in maintaining circulatory and respiratory stability and improving the quality of pulmonary collapse in SV-VATS. |
| first_indexed | 2024-03-13T08:17:34Z |
| format | Article |
| id | doaj.art-449556e6ef9b4714aa77eb3feb89fd85 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-13T08:17:34Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-449556e6ef9b4714aa77eb3feb89fd852023-05-31T13:03:11ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11459531145953Esketamine opioid-free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video-assisted thoracic surgery: a randomized controlled trialQisen Fan0Jinhui Luo1Qianling Zhou2Yaoliang Zhang3Xin Zhang4Jiayang Li5Long Jiang6Lan Lan7Department of Anesthesia, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Anesthesia, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, ChinaDepartment of Anesthesia, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Anesthesia, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Anesthesia, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaNational Clinical Research Center for Respiratory Disease and Departments of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Anesthesia, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaBackgroundOpioid-free anesthesia (OFA) provides adequate analgesia and can reduce postoperative opioid consumption, but its efficacy in spontaneous ventilation video-assisted thoracic surgery (SV-VATS) has not been demonstrated. We aimed to investigate the hypothesis that OFA could provide the same perioperative pain control as opioid anesthesia (OA), maintain safe and stable respiration and hemodynamics during surgery, and improve postoperative recovery.MethodsSixty eligible patients (OFA group: n=30; OA group: n=30) treated between September 15, 2022, and December 15, 2022, at The First Hospital of Guangzhou Medical University were included. They were randomized to receive standard balanced OFA with esketamine or OA with remifentanil combined with sufentanil. The primary outcome was the pain numeric rating score (NRS) at postoperative 24 h, and the secondary outcomes were intraoperative respiratory and hemodynamic data, opioid consumption, vasoactive drug dosage, and recovery in the post-anesthesia care unit and ward.ResultsThere was no significant difference in the postoperative pain scores and recovery quality between the two groups. The OFA group had a significantly lower dose of phenylephrine (P=0.001) and a lower incidence of hypotension (P=0.004) during surgery. The OFA group resumed spontaneous respiration faster (P<0.001) and had a higher quality of lung collapse (P=0.02). However, the total doses of propofol and dexmetomidine were higher (P=0.03 and P=0.02), and the time to consciousness was longer (P=0.039) in the OFA group.ConclusionsOFA provides the same level of postoperative pain control as OA, but it is more advantageous in maintaining circulatory and respiratory stability and improving the quality of pulmonary collapse in SV-VATS.https://www.frontiersin.org/articles/10.3389/fonc.2023.1145953/fullopioid-free anesthesiaopioid anesthesiaspontaneous ventilationvideo-assisted thoracic surgerymechanical ventilation |
| spellingShingle | Qisen Fan Jinhui Luo Qianling Zhou Yaoliang Zhang Xin Zhang Jiayang Li Long Jiang Lan Lan Esketamine opioid-free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video-assisted thoracic surgery: a randomized controlled trial Frontiers in Oncology opioid-free anesthesia opioid anesthesia spontaneous ventilation video-assisted thoracic surgery mechanical ventilation |
| title | Esketamine opioid-free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video-assisted thoracic surgery: a randomized controlled trial |
| title_full | Esketamine opioid-free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video-assisted thoracic surgery: a randomized controlled trial |
| title_fullStr | Esketamine opioid-free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video-assisted thoracic surgery: a randomized controlled trial |
| title_full_unstemmed | Esketamine opioid-free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video-assisted thoracic surgery: a randomized controlled trial |
| title_short | Esketamine opioid-free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video-assisted thoracic surgery: a randomized controlled trial |
| title_sort | esketamine opioid free intravenous anesthesia versus opioid intravenous anesthesia in spontaneous ventilation video assisted thoracic surgery a randomized controlled trial |
| topic | opioid-free anesthesia opioid anesthesia spontaneous ventilation video-assisted thoracic surgery mechanical ventilation |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1145953/full |
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