Opioid Free Anesthesia and Continuous Post-operative Pulse Oximetry Monitoring in the Obese Patient
Condition: Anesthesia
Study type: Interventional

Summary: 
      Anaesthesia has three major components, analgesia, muscle relaxation and hypnosis.

      For a long time, opioids have been covering the analgesia function. (1) When using opioids,
      an analgesic effect is obtained per-operatively, however, not without side-effects.
      Post-operative complications such as: respiratory depression, post-operative nausea and
      vomiting, pruritus, acute opioid tolerance and hyperalgesia, difficulty voiding and ileus,
      are well known.

      Opioid usage is an important risk factor of postoperative desaturation. Postoperative
      desaturation can lead to severe hypoxemia and even tissue hypoxia, followed by obvious
      cardiologic and neurological complications.

      Thus, in patients at risk, such as the obese patient, experts suggest reducing opioid usage.

      Non-opiate protocols implemented on the obese patient have been published. Non-opiate
      protocols have been established using a combination of ketamine, lidocaine and an alpha-2
      agonist.

      The main purpose of this pilot study is to evaluate whether patients undergoing an opioid
      free anaesthesia regime experience less desaturation episodes during the first 24 h
      post-bariatric surgery than patients having received an opioid anaesthesia regime.
    

Detailed description: 
      Anaesthesia has three major components, analgesia, muscle relaxation and hypnosis.

      For a long time, opioids have been covering the analgesia function. When using opioids, an
      analgesic effect is obtained per-operatively, however, not without side-effects.
      Post-operative complications such as: respiratory depression, post-operative nausea and
      vomiting, pruritus, acute opioid tolerance and hyperalgesia, difficulty voiding and ileus,
      are well known. These complications may lead to a prolonged hospital stay.

      Opioid usage is an important risk factor of postoperative desaturation. Postoperative
      desaturation can lead to severe hypoxemia and even tissue hypoxia, followed by obvious
      cardiologic and neurological complications.

      Thus, in patients at risk, such as the obese patient, experts suggest reducing opioid usage.

      Authors have indeed published non-opiate protocols implemented on the obese patient.

      Non-opiate protocols have been established using a combination of ketamine, lidocaine and an
      alpha-2 agonist.

      The main purpose of this pilot study is to evaluate whether patients undergoing an opioid
      free anaesthesia regime experience less desaturation episodes during the first 24 h
      post-bariatric surgery than patients having received an opioid anaesthesia regime.
    

Intervention name(s): Opioid free; opioid group
Intervention type(s): Combination Product; Combination Product
Intervention description(s): Peroperative opioid free anesthesia will be obtained via a combination of dexmedetomidine, ketamine, lidocaine and magnesium sulfate; Opioid anesthesia will follow the current standard approach of our hospital.
Other intervention name(s): study group; control group
Intervention MeSH terms: Analgesics, Opioid
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Diagnostic