Application of opioid-free anesthesia in elderly abdominal surgery
Objective:To evaluate the feasibility and application effect of opioid-free anesthesia in elderly abdomi-nal surgery.Methods:A total of 104 patients aged 65 to 85 years with abdominal surgery were enrolled.They were ran-domized into the OFA group(dexmedetomidine and lidocaine plus epidural analgesia)and OA group(sufentanil,refen-tanil plus epidural analgesia),with 52 cases in each group.The main indicators including visual analogue scale(VAS)within 24 hours after surgery,intraoperative and postoperative epidural analgesic drug consumption were observed.Sec-ondary indicators such as mean arterial pressure(MAP),heart rate(HR)at different moments during surgery,intraop-erative anesthesia effect,occurrence of adverse reactions within 24 hours after surgery were also recorded.Results:Compared with the OA group,the VAS score in the OFA group decreased after 8 hours after surgery(P＜0.001),and there was no significant difference in intraoperative epidural drug consumption between the two groups(P＞0.05).The cumulative epidural consumption of ropivacaine 24 hours after surgery in the OFA group was lower than that in the OA group(P＜0.001),and there was no significant difference in MAP and HR at different timepoints between the two groups(P＞0.05).There was no significant difference in the effect of intraoperative anesthesia between the two groups(P＞0.05).The postoperative recovery time and extubation time of the two groups were shorter than those in the OA group(P＜0.05).The incidence and severity of nausea and vomiting in the OFA group within 24 h after surgery were lower than those in the OA group(P＜0.05).Conclusion:For elderly abdominal surgery,the opioid-free anesthesia regimen provided in this study is feasible.Compared with opioid anesthesia regimen,intraoperative anesthesia has the same effect but shorter postoperative recovery time,which can also lower the severity of pain and reduce the incidence of nausea and vomiting within 24 h after surgery.
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