Opioid-Free Anesthesia Tolerated in Outpatient Surgery
Only 36% of patients request oral opioid meds in PACU despite receiving opioid-free anesthesia.
(HealthDay News) -- Opioid-free anesthesia is feasible and well-tolerated, and only 36% of patients requested oral opioids in the post-anesthesia care unit (PACU), according to a study presented at the annual meeting of the American Society of Anesthesiologists, being held Oct. 21 to 25 in Boston.
Enrico M. Camporesi, MD, from the University of South Florida in Tampa, and colleagues conducted a retrospective review of surgical cases of 1009 patients with a single anesthesiologist at an outpatient surgery center to describe the provision of anesthesia services without opioids. The opioid-free intraoperative anesthesia protocol included acetaminophen, magnesium, ketamine and lidocaine, and ketorolac (for adult patients if the surgeon allowed it). All patients also received Decadron, Zofran, and supplemental sevoflurane. Middle-ear surgery patients received gabapentin.
The researchers found that patients and surgeons reported satisfaction with the protocol for anesthesia, and postoperative pain management was well-tolerated. In the PACU, only 36% of patients requested oral opioid medications, with notably more pain medications for certain procedures, such as complex facial plastics and nasal/sinus surgeries with longer case lengths. More nausea medication was also required by patients in these two groups.
"In conclusion, safe anesthesia for multiple procedures varying in duration from an hour to several hours while using minimal opioids is possible," the authors write.
Camporesi EM, Samuels DJ, Melloni G, Dalvi P, Mangar D. Post-Operative Analgesia Requirements in 1,009 Consecutive Patients Receiving Opioid-Free Anesthesia. Abstract A3078. 2017 meeting of the American Society of Anesthesiologists. Boston.