Effect of opioid-free versus opioid-based strategies during multimodal anaesthesia on postoperative morphine consumption after bariatric surgery: a randomised double-blind clinical trial
Authors' conclusion
During bariatric surgery, a multimodal opioid-free anaesthesia technique did not decrease postoperative morphine consumption when compared with a multimodal opioid-based strategy. Quality of recovery did not differ between groups although the incidence of PONV was less in the opioid-free group.
Study context
- Population
- Class III obese patients having laparoscopic gastric bypass surgery; both groups received induction bolus of magnesium, lidocaine, ketamine, paracetamol, diclofenac and dexamethasone70% had OSA
- Participants
- 172 patients
- Comparison
- Opioid-free vs opioid-based multimodal anaesthesia
- Opioid-freen = 86
- Opioid-basedn = 86reference
- Primary endpoint
- Postoperative morphine consumption
- Follow-up
- 24 h
Methodological detailsdouble-blind, prospective
- Double-blind
- Prospective
Primary result
As reported in the abstract
24-h postoperative morphine consumption
No significant difference in postoperative morphine consumption, median [IQR] (the abstract does not say which group is which)
16 [13-26] vs 15 [10-24] mg
Secondary outcomes
Quality of recovery (QoR40) · up to POD 30
- Did not differ between groups
Safety
PONV · less frequent in the opioid-free group
P = 0.005
Hypoxaemia and bradycardia
- Not different between groups
Original publication
Effect of opioid-free versus opioid-based strategies during multimodal anaesthesia on postoperative morphine consumption after bariatric surgery: a randomised double-blind clinical trial. BJA Open. Published 23 February 2024. doi:10.
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