Effect of Opioid-free Analgesia and Anesthesia on the Quality of Postoperative Recovery and Nausea Vomit in Patients Receiving Laparoscopic Sleeve Gastrectomy

Last updated: May 7, 2024
Sponsor: Beijing Friendship Hospital
Overall Status: Active - Recruiting

Phase

N/A

Condition

Post-operative Nausea And Vomiting

Vomiting

Treatment

Opioid Anesthetics (sufentanil and remifentanil)

Opioid-free Analgesics (esketamine, dexmedetomidine)

Clinical Study ID

NCT06305221
opioid-free analgesia
  • Ages 18-65
  • All Genders

Study Summary

The purpose of the intraoperative use of opioids is to reduce the amount of sedative medication and to ensure effective analgesia. But pain is an unpleasant sensory and emotional experience (a cognitive perception) that cannot occur with sufficient depth of anesthesia (even without opioids). So a more reasonable explanation for analgesia should be anti-nociception and the resulting inhibition of the response to surgical stress. Since multiple mediators are involved in nociceptive pathways, antinociception can also be acquired through multiple mechanisms. However, there is no single ideal harm drug to replace opioids, which often requires two or more drugs to meet clinical needs. While regional block attenuates the stress response to surgery and sympathetic activation because of afferents to block nociceptive stimuli, and has an important role in the implementation of OFA. Combined with the clinical characteristics of the LSG, investigators developed the transverse abdominis fascia block (transversus abdominis plane TAP) in combination with esketamine (esketamine), dexmedetomidine (dexmedetomidine, DEX) of opioid-free anesthesia (opioid free anesthesia, OFA) and the analgesic regimen (TEDOFA), Reduce patient pain scores, nausea and vomiting after LSG based on perfect analgesia and adequate anti-sympathetic response, As well as the other complications, Promote the accelerated postoperative recovery of patients undergoing LSG, And reduce the incidence and severity of postoperative chronic pain.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients undergoing elective laparoscopic sleeve gastrectomy
  • ASAA I or grade;
  • volunteered in this trial and signed informed consent; ④ age 18-65 years; ⑤BMI> 30kg / m2.

Exclusion

Exclusion Criteria:

  • chronic pain;
  • severe liver dysfunction (total bilirubin 2 mg dl-1);
  • severe renal dysfunction (glomerular filtration rate 60ml min-1 1.73m-2);
  • pregnancy or lactation;
  • preoperative heart rate <50 beats / min, sick sinus syndrome, severe heart block; -dementia or significant neurological disorders (such as stroke, epilepsy,intracranial tumors, PD, etc.);
  • history of alcohol or drug abuse

Study Design

Total Participants: 76
Treatment Group(s): 2
Primary Treatment: Opioid Anesthetics (sufentanil and remifentanil)
Phase:
Study Start date:
March 09, 2024
Estimated Completion Date:
March 31, 2025

Connect with a study center

  • bijia Song

    Beijing,
    China

    Active - Recruiting

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