Anesthesia: Essays and Researches

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 13  |  Issue : 2  |  Page : 199--203

Opioid-free total intravenous anesthesia improves postoperative quality of recovery after ambulatory gynecologic laparoscopy


Karim Youssef Kamal Hakim, Wahba Zakaria Bekhet Wahba 
 Department of Anesthesia, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Karim Youssef Kamal Hakim
Department of Anesthesia, Faculty of Medicine, Ain Shams University, Cairo
Egypt

Background: Gynecological laparoscopic surgery is commonly performed on an ambulatory basis under general anesthesia. The postoperative quality of recovery (QOR) should be considered one of the principal endpoints after ambulatory surgery. Total intravenous anesthesia (TIVA) with opioids is known to improve postoperative QOR after ambulatory surgery. However, opioids can be associated with an increased incidence of postoperative complications, which can affect postoperative QOR. The primary aim of this study was to compare the patient recovery using the QOR-40 at 24 h postoperative in ambulatory gynecological laparoscopy between opioid-free (OF) TIVA and opioid-based TIVA. Settings and Design: A prospective, randomized, controlled, comparative study was conducted at the day surgery center. Patients and Methods: Eighty females were included in the study. They were randomized into two equal groups: OF TIVA group with dexmedetomidine and propofol or opioid-based TIVA (O) group with fentanyl and propofol. The primary outcome was QOR-40 at 24 h postoperative, and the secondary outcomes were postoperative numerical rating scale (NRS), time to first rescue analgesia, number of rescue tramadol analgesia, and the incidence of postoperative nausea and vomiting. Results: A statistically significant difference in total QOR-40 score at 24 h postoperative was observed between the groups (median [range] QOR-40 of 182.0 [164.0–192.0] in the OF TIVA group and 170.0 [156.0–185.0] in the O group; P = 0.03). OF group had significantly lower time to first rescue analgesia, maximum NRS pain scores, number of rescue tramadol analgesia, and ondansetron use. Conclusions: OF TIVA significantly improves postoperative QOR in patients undergoing ambulatory gynecological laparoscopic surgery.


How to cite this article:
Hakim KY, Wahba WZ. Opioid-free total intravenous anesthesia improves postoperative quality of recovery after ambulatory gynecologic laparoscopy.Anesth Essays Res 2019;13:199-203


How to cite this URL:
Hakim KY, Wahba WZ. Opioid-free total intravenous anesthesia improves postoperative quality of recovery after ambulatory gynecologic laparoscopy. Anesth Essays Res [serial online] 2019 [cited 2019 Aug 18 ];13:199-203
Available from: http://www.aeronline.org/article.asp?issn=0259-1162;year=2019;volume=13;issue=2;spage=199;epage=203;aulast=Hakim;type=0