Opioid-free Anesthesia in Thoracic Surgery

Study Overview
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Brief Summary
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No study has been conducted to demonstrate the feasibility and safety of an Opioid-Free Anesthesia (OFA) protocol compared to Opioid-Based Anesthesia (OBA) in thoracic surgery, at risk for intense post-operative pain, to improve patient care. The aim of the present study was to evaluate the effect of OFA on post-operative opioids consumption, pain and the post-operative period after lobectomy by Video-Assisted Thoracoscopy Surgery (VATS). systems. Investigators perform a retrospective, single-center study in 2019. Patients were divided into two groups: OFA (with dexmedetomidine) or OBA (sufentanyl). Investigators analyse the total postoperative opioid consumption in the 48 h after surgery. Investigators asses pain intensity in the 48 h after surgery, operative hemodynamic stability, Post-Operative Pain (POP) in Post-Anesthesia Care Unit (PACU) and POP on day 30. All data are available in the medical record Hypothesis: OFA can reduce post-operative opioids consumption, pain in lobectomy by video-assisted thoracoscopy surgery (VATS).

Official Title
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Effect of Opioid-free Anesthesia on Perioperative Period After Video-assisted Thoracoscopic Lobectomy: a Retrospective Study

Conditions
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Thoracic, Surgery

Intervention / Treatment
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* Other: Post-operative care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All consecutive patients admitted for lobectomy or wedge video-assisted thoracoscopy Opioid Free Anesthesia (OFA) administration was left to the discretion of the attending anesthetist according to his or her practices and habits. age 18 or over lobectomy or wedge resection by Video-Assisted Thoracoscopy Surgery (VATS) Exclusion Criteria: toxicomania, epidural analgesia use, thoracotomy conversion Patient-Controlled Analgesia with morphine (PCA) Patient who object to take part of the study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group opioid free anesthesia<br>Patient benefit of the opioid free anesthesia protocol | Other: Post-operative care<br>* Retrospective collection of clinical data recorded in the electronic medical record. The following variables were continuously recorded in the institutional database: age, gender, body weight, height, personal medical history, American Society of Anesthesiologists (ASA) score, type of thoracic surgery, the duration of surgery, duration of anesthesia (from intubation to extubation), the duration of PACU stay, the need for morphine titration, epinephrine, norepinephrine. For data at day 30, the vast majority of patients were included in the enhanced recovery program and as such benefited from a consultation at 1 month with a coordination nurse who collected data on post-operative pain in a standardized manner. All data was extracted from investigators institutional database and collected by a physician who was not involved in the care of the study patients.<br>|
| Group opioid based anesthesia<br>Patient don't benefit of the opioid free anesthesia protocol | Other: Post-operative care<br>* Retrospective collection of clinical data recorded in the electronic medical record. The following variables were continuously recorded in the institutional database: age, gender, body weight, height, personal medical history, American Society of Anesthesiologists (ASA) score, type of thoracic surgery, the duration of surgery, duration of anesthesia (from intubation to extubation), the duration of PACU stay, the need for morphine titration, epinephrine, norepinephrine. For data at day 30, the vast majority of patients were included in the enhanced recovery program and as such benefited from a consultation at 1 month with a coordination nurse who collected data on post-operative pain in a standardized manner. All data was extracted from investigators institutional database and collected by a physician who was not involved in the care of the study patients.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cumulative dose of postoperative opioid | The primary endpoint was the cumulative dose of postoperative opioid in the first 48 h (D2) (in milligrams of oral morphine equivalent) which included morphine and tramadol after conversion (1mg of intra-veinous morphine = 3 mg of oral morphine, and 10 mg of oral morphine = 50 mg of oral tramadol) | 48 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Post-operative pain