Journal of pharmacy & bioallied sciences · 2025
To Compare Opioid Based versus Opioid-Free Anesthesia (Integrating with Erector Spinae Plane Block) in Laparoscopic Surgeries - A Prospective Study.
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Gandhi Monika, Mouna Nelapati, Sharma Aseem, Shukla Prachi, Banjare Manish
Аннотация
BACKGROUND: Opioid-free anesthesia (OFA) using multimodal analgesia and erector spinae plane block (ESPB) has shown promise in reducing opioid-related side effects in laparoscopic surgeries. We compared postoperative pain scores, intraoperative hemodynamics, analgesic requirements, and side effects between OFA with ESPB and opioid-based anesthesia (OBA).
MATERIAL AND METHODS: Sixty patients undergoing elective laparoscopic surgery were randomized into two groups (n = 30 each). Group A received OFA with lignocaine, magnesium sulfate, paracetamol, and bilateral ESPB. Group B received OBA with fentanyl. Pain scores (visual analog scale [VAS]), intraoperative heart rate, mean arterial pressure, analgesic consumption, and adverse events were recorded and analyzed.
RESULTS: VAS scores were significantly lower in Group A at 1, 2, 3, 4, 16, and 24 h postoperatively (P < 0.05). Group A showed greater hemodynamic stability and required significantly fewer rescue analgesics. Mean time to first analgesia was longer in Group A (12.93 ± 3.81 h) versus Group B (1.70 ± 0.92 h; P = 0.001). Adverse events were more common in Group B but not statistically significant.
CONCLUSION: OFA with ESPB provides superior postoperative analgesia, better hemodynamic stability, and reduces opioid consumption and related side effects in laparoscopic surgeries.
MATERIAL AND METHODS: Sixty patients undergoing elective laparoscopic surgery were randomized into two groups (n = 30 each). Group A received OFA with lignocaine, magnesium sulfate, paracetamol, and bilateral ESPB. Group B received OBA with fentanyl. Pain scores (visual analog scale [VAS]), intraoperative heart rate, mean arterial pressure, analgesic consumption, and adverse events were recorded and analyzed.
RESULTS: VAS scores were significantly lower in Group A at 1, 2, 3, 4, 16, and 24 h postoperatively (P < 0.05). Group A showed greater hemodynamic stability and required significantly fewer rescue analgesics. Mean time to first analgesia was longer in Group A (12.93 ± 3.81 h) versus Group B (1.70 ± 0.92 h; P = 0.001). Adverse events were more common in Group B but not statistically significant.
CONCLUSION: OFA with ESPB provides superior postoperative analgesia, better hemodynamic stability, and reduces opioid consumption and related side effects in laparoscopic surgeries.