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Revista de la Sociedad Española del Dolor
versión impresa ISSN 1134-8046
Resumen
MILLAN-BUENO, MP; SORIANO-PEREZ, ÁM y ALADOS-ARBOLEDAS, FJ. OFA in major surgery. Experience at a secondary level hospital. Rev. Soc. Esp. Dolor [online]. 2022, vol.29, n.1, pp.8-14. Epub 05-Oct-2022. ISSN 1134-8046. https://dx.doi.org/10.20986/resed.2022.3991/2022.
Introduction:
Opioid free anaesthesia is a new paradigm that focuses in multimodal analgesia with an opioid sparing approach that provides a good pain management, without nauseas nor vomiting and improves prognosis in oncological patients
Patients and method:
Cases retrospective study of major surgery patients from november 2018 to february 2020. Main objective: type and dosage of opioid requeriments both in the intraoperatory and postoperative setting. Secondary objectives: pain level score cuantification at the end of the surgery and at leaving the postoperative recovery unit and incidence of nausea/vomiting
Results:
157 patients were recruited. 29,9 % need no opioid intraoperatively. Those who requiered it, 72,7 % only needed morphine (3,3 mg ± 0,9), 8,1 % had to recieved fentanyl (110,1 mcg, ± 57,1) and 19,2 % need both morphine and fentanyl (3,8 mg ± 1,2 and 90,4 mcg ± 62,4). At the postoperative recovery unit, only 31,7 % precised opioids: ⅔ (33 patients) recieved morphine (4,8 mg ± 2,6), 1/5 (10 patients) only fentanyl (83,3 mcg ± 28,8) and the rest needed a combination of fentanyl and morphine (140,6 mcg ± 119,4 and 8 mg ± 5,9, respectively). Two of them have nausea or vomyting.
Conclusions:
An opioid free anaesthesia approach is feasible in major surgery patients and it achieves and adequate pain management. Opioid requeriments in such patients is less than in those who recieved a traditional base opioid analgesia protocol.
Palabras clave : Opioid free anaesthesia; multimodal analgesia; major surgery; esmolol.