Standard opioid-containing versus opioid-sparing anesthesia on early postoperative recovery after video-assisted thoracic surgery: A propensity-weighted analysis
PurposeOpioids have several adverse effects. At present, there are no large clinical studies on the effects of opioid-sparing anesthesia on early postoperative recovery after thoracoscopic surgery. This study was to investigate the effects of opioid-sparing anesthesia on early postoperative recovery...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-10-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1015467/full |
| _version_ | 1828140827346468864 |
|---|---|
| author | Yan-yu Jiang Yan-yu Jiang Zhen-ping Li Ming Yao Qing-he Zhou Qing-he Zhou |
| author_facet | Yan-yu Jiang Yan-yu Jiang Zhen-ping Li Ming Yao Qing-he Zhou Qing-he Zhou |
| author_sort | Yan-yu Jiang |
| collection | DOAJ |
| description | PurposeOpioids have several adverse effects. At present, there are no large clinical studies on the effects of opioid-sparing anesthesia on early postoperative recovery after thoracoscopic surgery. This study was to investigate the effects of opioid-sparing anesthesia on early postoperative recovery after thoracoscopic surgery.MethodsAdult patients who underwent video-assisted thoracic surgery from 1 January 2019 to 28 February 2021 were enrolled by reviewing the electronic medical records. Participants were divided into opioid-sparing anesthesia (OSA group) and opioid-containing anesthesia (STD group) based on intraoperative opioid usage. The propensity-score analysis was to compare the early postoperative recovery of two groups. The outcome measurements included the incidence of postoperative nausea and vomiting (PONV) during an entire hospital stay, need for rescue antiemetic medication, postoperative-pain episodes within 48 h after surgery, need for rescue analgesia 48 h postoperatively, duration of postoperative hospital stay, length of PACU stay, postoperative fever, postoperative shivering, postoperative atrial fibrillation, postoperative pulmonary infection, postoperative hypoalbuminemia, postoperative hypoxemia, intraoperative blood loss, and intraoperative urine output.ResultsA total of 1,975 patients were identified. No significant difference was observed in patient characteristics between the OSA and STD groups after adjusting for propensity score-based inverse probability treatment weighting. The incidence of postoperative nausea and vomiting was significantly lower in the OSA group than in the STD group (14.7% vs. 18.9%, p = 0.041). The rescue antiemetic use rate was lower in the OSA group than in the STD group (7.5% vs.12.2%; p = 0.002). PACU duration was longer in the OSA group than in the STD group (70.8 ± 29.0 min vs. 67.3 ± 22.7 min; p = 0.016). The incidence of postoperative fever was higher in the STD group than that in the OSA group (11.0% vs.7.7%; p = 0.032). There were no differences between the groups in terms of other outcomes.ConclusionsOur results suggest that opioid-sparing anesthesia has a lower incidence of postoperative complications than opioid-based anesthetic techniques. |
| first_indexed | 2024-04-11T19:15:42Z |
| format | Article |
| id | doaj.art-970e97127853421fa1bcb3a2c1eef154 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T19:15:42Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-970e97127853421fa1bcb3a2c1eef1542022-12-22T04:07:27ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-10-01910.3389/fsurg.2022.10154671015467Standard opioid-containing versus opioid-sparing anesthesia on early postoperative recovery after video-assisted thoracic surgery: A propensity-weighted analysisYan-yu Jiang0Yan-yu Jiang1Zhen-ping Li2Ming Yao3Qing-he Zhou4Qing-he Zhou5Graduate School, Bengbu Medical College, Bengbu, ChinaGraduate School, Bengbu Medical College, Bengbu, ChinaGraduate School, Bengbu Medical College, Bengbu, ChinaGraduate School, Bengbu Medical College, Bengbu, ChinaGraduate School, Bengbu Medical College, Bengbu, ChinaDepartment of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, Jiaxing, ChinaPurposeOpioids have several adverse effects. At present, there are no large clinical studies on the effects of opioid-sparing anesthesia on early postoperative recovery after thoracoscopic surgery. This study was to investigate the effects of opioid-sparing anesthesia on early postoperative recovery after thoracoscopic surgery.MethodsAdult patients who underwent video-assisted thoracic surgery from 1 January 2019 to 28 February 2021 were enrolled by reviewing the electronic medical records. Participants were divided into opioid-sparing anesthesia (OSA group) and opioid-containing anesthesia (STD group) based on intraoperative opioid usage. The propensity-score analysis was to compare the early postoperative recovery of two groups. The outcome measurements included the incidence of postoperative nausea and vomiting (PONV) during an entire hospital stay, need for rescue antiemetic medication, postoperative-pain episodes within 48 h after surgery, need for rescue analgesia 48 h postoperatively, duration of postoperative hospital stay, length of PACU stay, postoperative fever, postoperative shivering, postoperative atrial fibrillation, postoperative pulmonary infection, postoperative hypoalbuminemia, postoperative hypoxemia, intraoperative blood loss, and intraoperative urine output.ResultsA total of 1,975 patients were identified. No significant difference was observed in patient characteristics between the OSA and STD groups after adjusting for propensity score-based inverse probability treatment weighting. The incidence of postoperative nausea and vomiting was significantly lower in the OSA group than in the STD group (14.7% vs. 18.9%, p = 0.041). The rescue antiemetic use rate was lower in the OSA group than in the STD group (7.5% vs.12.2%; p = 0.002). PACU duration was longer in the OSA group than in the STD group (70.8 ± 29.0 min vs. 67.3 ± 22.7 min; p = 0.016). The incidence of postoperative fever was higher in the STD group than that in the OSA group (11.0% vs.7.7%; p = 0.032). There were no differences between the groups in terms of other outcomes.ConclusionsOur results suggest that opioid-sparing anesthesia has a lower incidence of postoperative complications than opioid-based anesthetic techniques.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1015467/fullopioid-sparing anesthesiavideo-assisted thoracic surgerypostoperative nausea and vomitinginverse probability treatment weightingpostoperative recovery |
| spellingShingle | Yan-yu Jiang Yan-yu Jiang Zhen-ping Li Ming Yao Qing-he Zhou Qing-he Zhou Standard opioid-containing versus opioid-sparing anesthesia on early postoperative recovery after video-assisted thoracic surgery: A propensity-weighted analysis Frontiers in Surgery opioid-sparing anesthesia video-assisted thoracic surgery postoperative nausea and vomiting inverse probability treatment weighting postoperative recovery |
| title | Standard opioid-containing versus opioid-sparing anesthesia on early postoperative recovery after video-assisted thoracic surgery: A propensity-weighted analysis |
| title_full | Standard opioid-containing versus opioid-sparing anesthesia on early postoperative recovery after video-assisted thoracic surgery: A propensity-weighted analysis |
| title_fullStr | Standard opioid-containing versus opioid-sparing anesthesia on early postoperative recovery after video-assisted thoracic surgery: A propensity-weighted analysis |
| title_full_unstemmed | Standard opioid-containing versus opioid-sparing anesthesia on early postoperative recovery after video-assisted thoracic surgery: A propensity-weighted analysis |
| title_short | Standard opioid-containing versus opioid-sparing anesthesia on early postoperative recovery after video-assisted thoracic surgery: A propensity-weighted analysis |
| title_sort | standard opioid containing versus opioid sparing anesthesia on early postoperative recovery after video assisted thoracic surgery a propensity weighted analysis |
| topic | opioid-sparing anesthesia video-assisted thoracic surgery postoperative nausea and vomiting inverse probability treatment weighting postoperative recovery |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1015467/full |
| work_keys_str_mv | AT yanyujiang standardopioidcontainingversusopioidsparinganesthesiaonearlypostoperativerecoveryaftervideoassistedthoracicsurgeryapropensityweightedanalysis AT yanyujiang standardopioidcontainingversusopioidsparinganesthesiaonearlypostoperativerecoveryaftervideoassistedthoracicsurgeryapropensityweightedanalysis AT zhenpingli standardopioidcontainingversusopioidsparinganesthesiaonearlypostoperativerecoveryaftervideoassistedthoracicsurgeryapropensityweightedanalysis AT mingyao standardopioidcontainingversusopioidsparinganesthesiaonearlypostoperativerecoveryaftervideoassistedthoracicsurgeryapropensityweightedanalysis AT qinghezhou standardopioidcontainingversusopioidsparinganesthesiaonearlypostoperativerecoveryaftervideoassistedthoracicsurgeryapropensityweightedanalysis AT qinghezhou standardopioidcontainingversusopioidsparinganesthesiaonearlypostoperativerecoveryaftervideoassistedthoracicsurgeryapropensityweightedanalysis |