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ISSN 1561-3194 (Electronic)

2020, Number 5

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Rev Ciencias Médicas 2020; 24 (5)

Advantages of opioid-free intravenous anesthesia over anesthesia in ambulatory breast cancer surgery

López GO, Ortega VME, Ravelo LW, Cardenas TYY, Valdés MJA

Language: Spanish
References: 14
Page: 1-10
PDF size: 313.05 Kb.


ABSTRACT

Introduction: opioid-free general anesthesia arises from the need to avoid the use of opioids in the transoperative period and the undesirable effects in the postoperative period.
Objective: to assess the hemodynamic behavior and anesthetic recovery in patients who underwent ambulatory surgery for breast cancer and those who were given either opioid-free intravenous general or balanced general anesthesia.
Methods: a quasi-experimental, prospective study was carried out on patients who received balanced general anesthesia (n=34) and total opioid-free intravenous anesthesia (n=34), who underwent breast cancer surgery at Abel Santamaria Cuadrado General Teaching Hospital during 2018.
Results: the group of balanced general anesthesia showed greater intraoperative variation of the parameters assessed, with significant differences (p=0.019). The mean time of awakening was lower in the intravenous total anesthesia group (2.10 ± 0,907 min vs. 5,35 ± 1,250 min; p<0.01), as was pain, with significant difference (p<0.05) and the recovery time, where one hour after the surgery, 85 % met the criteria for anesthesia discharge. The delay in discharge from the recovery unit occurred mainly because of the low level of motor activity, with a higher incidence in the group of balanced general anesthesia (71% vs. 26 %; p=0.00).
Conclusions: intravenous opioid-free total anesthesia was higher to the balanced general approach because it showed greater hemodynamic and analgesic stability, lower incidence of postoperative complications, and shorter time spent in the post-anesthesia recovery room.


REFERENCES

  1. Archundia García A. Cirugía 1. Educación quirúrgica, 6ed. New York: McGrawHill; 2017.

  2. Vargas-Hernández JJ. Anestesia libre de opioides. Rev Mex Anestesiol [Internet]. 2014 [citado 15/08/2020]; 37(Supl1): 24-27. Disponible en: Disponible en: https://www.medigraphic.com/pdfs/rma/cma-2014/cmas141i.pdf

  3. Chávez-Díaz IF, Nava-López JA. Anestesia libre de opioides. La reivindicación de los «adyuvantes». Rev Mex Anestesiol [Internet]. 2015 [citado 15/08/2020]; 38(Supl1): 310-313. Disponible en: Disponible en: https://www.medigraphic.com/pdfs/rma/cma-2015/cmas151cc.pdf

  4. Beattie J, Tisdale MA. Current Opinion in Supportive and Palliative Care. Clinic mayo [Internet]. 2008 [citado 15/08/2020]; 2(4): [aprox. 10p]. Disponible en: Disponible en: https://mayoclinic.pure.elsevier.com/en/publications/current-opinion-in-supportive-and-palliative-care-editorial-intro

  5. Bakan M, Umutoglua T, Topuza U, Harun Uysala, Bayramb M, Kadiogluc H, et al. Anestesia venosa total libre de opiáceos, con infusiones de propofol, dexmedetomidina y lidocaína para la colecistectomía laparoscópica: estudio prospectivo, aleatorizado y doble ciego. Rev Bras Anestesiol [Internet]. 2015 [citado 15/08/2020]; 65(3):191-199. Disponible en: Disponible en: https://www.sciencedirect.com/science/article/pii/S2255496315000227

  6. Mulier J. Anestesia libre de opioides: ¿un cambio de paradigma? Revista Española de Anestesiología y Reanimación [Internet]. 2017 [citado 15/08/2020]; 64(8): 427-430. Disponible en: Disponible en: https://www.elsevier.es/en-revista-revista-espanola-anestesiologia-reanimacion-344-articulo-anestesia-libre-opioides-un-cambio-S0034935617300695

  7. Connolly C, Buggy D. Opioids and tumour metastasis: does the choice of the anesthetic-analgesic technique influence outcome after cancer surgery? Curr Opin Anesthesiol [Internet]. 2016 [citado 15/08/2020]; 29(4):468-474. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/27214644/

  8. Boysen PG, Pappas MM, Evans B. An Evidence-Based Opioid-Free Anesthetic Technique to Manage Perioperative and Periprocedural Pain. Ochsner J [Internet]. 2018 [citado 15/08/2020]; 18(2): 121-125. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6135289/

  9. Fierro Díaz GA, Vanegas Mendieta JM, Beltrán Gallegos AB. Anestesia, analgesia, reumatología y alivio del dolor agudo y crónico. Rev Cuba Reumatol [Internet]. 2019 [citado 15/08/2020]; 21(1):56. Disponible en: Disponible en: http://www.revreumatologia.sld.cu/index.php/reumatologia/article/view/679

  10. Naranjo-González M. Anestesia libre de opioides en cirugía ambulatoria. Rev Mex Anestesiolog [Internet]. 2015 [citado 15/08/2020]; 38(Supl1):156-158. Disponible en: Disponible en: https://www.medigraphic.com/pdfs/rma/cma-2015/cmas151ah.pdf

  11. Mefkur B, Tarik U, Ufuk T, Harun U, Mehmet B. Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study. Braz J Anesth [Internet]. 2015 [citado 15/08/2020]; 65(3): 191-199. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/25925031/

  12. Lavand homme P, Estebe JP. Opioid-free anesthesia: a different regard to anesthesia practice. Rev. Anest [Internet]. 2018 [citado 15/08/2020]; 31(5):1. Disponible en: Disponible en: https://www.researchgate.net/publication/326352067_Opioid-free_anesthesia_a_different_regard_to_anesthesia_practice

  13. Vincent A , Bernald L, Leonel M. Farmacología de los anestésicos locales. Rev Anest y Reanimac [Internet]. 2019 [citado 15/08/2020]; 45(1):1-19. Disponible en: Disponible en: https://www.sciencedirect.com/science/article/pii/S1280470318415526

  14. Hameurlaine S, Kock M. Should opioid free anesthesia be integrated in enhanced recovery protocols?. Acta Anaesth. Belg [Internet]. 2018 [citado 15/08/2020]; 69(2): 77-83. Disponible en: Disponible en: https://www.researchgate.net/publication/327364310_Editorial_Should_opioid_free_anesthesia_be_integrated_in_enhanced_recovery_protocols




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