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Since the 1990s, the concept of anesthesia without morphine (OFA) has been developed. The principle is based on the fact that in a sleeping patient a sympathetic reaction marked by hemodynamic changes does not reflect a painful phenomenon, that a painful phenomenon in a sleeping patient is not memorized, that hormonal stress, sympathetic reaction and inflammatory reaction can be controlled by therapeutic classes other than a morphine agent. This therapeutic management would avoid the side effects associated with the use of morphine. In cardiac surgery, no studies have evaluated the effect of an OFA on morphine consumption and on a post-operative composite endpoint. Lidocaine was only studied in the context of cardioprotection and neuroprotection. Studies found a cardioprotective effect with a decrease in episodes of rhythmic disorders, and neuroprotective with a non-constant improvement in postoperative cognitive functions, but all these studies were performed during opioid anaesthesia (opioid agent use)/ The purpose of our study is to demonstrate that general anesthesia without opioid (OFA) is associated with a decrease in post-operative morphine consumption and an improvement in the patient's post-operative well-being (complications, confusion, vigilance, length of stay).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Opioid free anaesthesia | patient anesthtesized with lidocaine, ketamine and dexamethasone |
| |
| Opioid anaesthesia | patients anesthetized with sufentanil ketamine and dexamethasone |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Opioid free anaesthesia | Procedure | patient anesthtesized with lidocaine, ketamine and dexamethasone |
|
| Measure | Description | Time Frame |
|---|---|---|
| Morphine consumption | Total morphine consumption over the first 48 post operative hours in milligrammes | Day 2 |
| Complications | composite end point of post operative complications (cardiac, neurological, renal, respiratory) | Day 7 |
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Inclusion Criteria:
Exclusion Criteria:
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Cardiac surgical
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chu Dijon Bourogne | Dijon | 21000 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31366330 | Result | Guinot PG, Spitz A, Berthoud V, Ellouze O, Missaoui A, Constandache T, Grosjean S, Radhouani M, Anciaux JB, Parthiot JP, Merle JP, Nowobilski N, Nguyen M, Bouhemad B. Effect of opioid-free anaesthesia on post-operative period in cardiac surgery: a retrospective matched case-control study. BMC Anesthesiol. 2019 Jul 31;19(1):136. doi: 10.1186/s12871-019-0802-y. |
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| Opioid anaesthesia | Procedure | patients anesthetized with sufentanil ketamine and dexamethasone |
|