Cardiothoracic & vascular anesthesia
Opioid-Free Versus Opioid-Based Anesthesia on Postoperative Pain After Thoracoscopic Surgery: The Use of Intravenous and Epidural Esketamine
Primary result · Mild chronic postoperative painResult — go to the resultOdds ratio 3.52 95% CI 1.49–8.31Authors' conclusion
Replacement of opioids by esketamine, intraoperatively as intravenous injection and epidural infusion and postoperatively as epidural infusion, reduces the incidence of mild chronic postoperative pain and side effects in patients after VATS.
Study context
- Population
- Lung tumour patients scheduled for video-assisted thoracoscopic surgery (VATS)159 analysed
- Participants
- 162 patients
- Comparison
- Opioid-free anaesthesia vs opioid-based anaesthesia
- OAn = 79reference
- Opioid-free anesthesia (OFA)n = 80
- Primary endpoint
- Chronic pain rate (logistic regression)
- Follow-up
- 3 months after VATS
Methodological details2-centre, September 2021 to January 2022
- 2-centre
- September 2021 to January 2022
Primary result
Mild chronic postoperative pain · 3 months
Odds ratio
3.52
95% CI 1.49–8.31
P = 0.004
Events by treatment group
OA vs OFA
OR 3.52 (95% CI 1.49–8.31); P = 0.004
As reported in the abstract
Secondary outcomes
| Outcome | OA | OFA | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Mild chronic pain · 6 months | 29.1% | 11.3% | 5.55 (2.01–15.33) | P = 0.001 | |
| Acute postoperative pain · 24 hours | 0% | 17.5% | 52.14 (6.47–420.10) | P < 0.001 | |
| Acute postoperative pain · 48 hours | 3.8% | 2.5% | 2.07 (0.99–4.32) | P = 0.053 | |
| 0.050.21520Odds ratio (log scale) |
Safety
Side effects (nausea, vomiting, pruritus) · 48 hours after surgery
- Fewer patients with side effects in the OFA group
Original publication
Opioid-Free Versus Opioid-Based Anesthesia on Postoperative Pain After Thoracoscopic Surgery: The Use of Intravenous and Epidural Esketamine. Anesth Analg. Published 14 July 2023. doi:10.
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