Background: Opioid-free anesthesia (OFA) has emerged as a potential alternative treatment for obese individuals undergoing laparoscopic abdominal surgery. Objective: The goal of this work aimed to compare the safety and efficacy of opioid-based anesthesia (OBA) versus OFA in obese patients having laparoscopic cholecystectomy.
Material and methods: This randomized, prospective, double-blind clinical study was conducted with 50 obese patients scheduled for laparoscopic cholecystectomy. Patients were randomly assigned to either the opioid-based anesthesia group (Group I) or the opioid-free anesthesia group (Group II). Group I obtained fentanyl as the primary anesthetic adjuvant and perioperative analgesic, while group II obtained dexmedetomidine, lidocaine, and paracetamol as alternative analgesics. Hemodynamic parameters, pain scores, and opioid usage were measured at various time points. Adverse effects were also captured.
Results: OFA resulted in significantly lower mean arterial blood pressure and significantly lower postoperative VAS score. The total consumption of opioid in the form of pethidine was significantly reduced in the OFA group than the OBA group (40.4 ± 28.21 vs. 71.8 ± 35.73 respectively, P 0.05).
Conclusions: Anesthesia management for morbidly obese individuals undergoing laparoscopic cholecystectomy under general anesthesia may benefit from the use of anesthesia devoid of opioids. |
