Quality of Recovery Following Opioids Free Anaesthesia in Laparoscopic Sleeve Gastrectomy

Al Mashfa Medical Center

Status: Completed

Conditions: Narcotics; Bariatric Surgery; Analgesia; Recovery Quality

Treatments: Drug: Dexmedetomidine Injection [Precedex]; Drug: Fentanyl; Drug: Lidocaine; Drug: Ketamine; Procedure: Oblique subcostal transversus abdominis plane block

Study type: Interventional

Funder types: Other

Identifiers

NCT04285255

OFA

Details and patient eligibility

About

Laparoscopic sleeve gastrectomy is widely employed nowadays. Multimodal analgesia approach is implemented within the enhanced recovery protocol in our facility to improve participants' recovery. Due to side effects of narcotics, the may adversely affect the quality of recovery, the investigators intended to test the efficacy of opioids free anaesthesia on the quality of recovery and postoperative narcotic use.

Enrollment: 103 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 70 ASA II - III adult patients (18-60 years old)
• Elective laparoscopic bariatric surgery.
• Body mass index (BMI) is from 40 to 60
• Trocar sites at or above the umbilicus (T 10 dermatome).

Exclusion criteria

• Allergy to amino-amide local anaesthetics,
• presence of coagulopathy
• local skin infection at injection sites,
• preoperative chronic dependence upon opioid and NSAID medications,
• liver or renal insufficiency,
• history of psychiatric or neurological disease, deafness,
• previous open surgery,
• patients who need to be converted to open surgery with more tissue trauma,
• ASA (American society of anesthesiologists) class above III were excluded.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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103 participants in 2 patient groups

Opioids anesthesia

Active Comparator group

Description:

received propofol-fentanyl induction of anaesthesia plus ultrasound-guided Bilateral oblique subcostal TAP block using 20ml of bupivacaine hydrochloride 0.25% (Marcaine, Astra Zeneca UK) in each side (total volume of 40 ml) deposited equally on each side

Treatment:

Procedure: Oblique subcostal transversus abdominis plane block

Drug: Fentanyl

OFA

Active Comparator group

Description:

received preinduction with dexmeditomidine 0.1µg.kg-1 over 10 min. Induction with propofol 1.5 mg.kg-1-ketamine (ketofol 3:1 mixture) induction plus maintenance mixture of dexmedetomidine 0.5µg.kg-1.h-1, ketamine 0.5mg.kg-1.h-1, and lidocaine 1 mg.kg-1.h-1 plus ultrasound-guided Bilateral oblique subcostal TAP block using 20ml of bupivacaine hydrochloride 0.25% (Marcaine, Astra Zeneca UK) in each side (total volume of 40 ml) deposited equally on each side

Treatment:

Procedure: Oblique subcostal transversus abdominis plane block

Drug: Ketamine

Drug: Lidocaine

Drug: Dexmedetomidine Injection [Precedex]