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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Opioids anesthesia | Active Comparator | 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 |
|
| OFA | Active Comparator | 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 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fentanyl | Drug | opioids anaesthesia |
| |
| Ketamine |
| Measure | Description | Time Frame |
|---|---|---|
| Quality of recovery 40 questionnaire (QoR-40) | postoperative quality of recovery | At 6 hours |
| Quality of recovery 40 questionnaire (QoR-40) | postoperative quality of recovery | At 24th h (period of time between 6 and 24 hours) as repeated measurement |
| Measure | Description | Time Frame |
|---|---|---|
| Pethidine consumption | 24 hours | |
| Numerical rating scale (NRS) | visual analogue scale postoperatively | 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Al Mashfa medical center | Khobar | Eastern Provence | 34225/7564 | Saudi Arabia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35062872 | Derived | Ibrahim M, Elnabtity AM, Hegab A, Alnujaidi OA, El Sanea O. Combined opioid free and loco-regional anaesthesia enhances the quality of recovery in sleeve gastrectomy done under ERAS protocol: a randomized controlled trial. BMC Anesthesiol. 2022 Jan 21;22(1):29. doi: 10.1186/s12871-021-01561-w. |
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only the anaesthetist is one aware of the study groups
| Drug |
ketamine induction and analgesia as opioids free anaesthesia versus opioids analgesia |
|
| Dexmedetomidine Injection [Precedex] | Drug | alpha 2 agonist with sedative, analgesic effect |
|
| Oblique subcostal transversus abdominis plane block | Procedure | Bupivacaine 0.25% injected under ultrasound usage in the transversus abdominis plane |
|
| Lidocaine | Drug | infusion of lidocaine 2%(1mg/kg/h) |
|
| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D005283 | Fentanyl |
| D007649 | Ketamine |
| D020927 | Dexmedetomidine |
| D008012 | Lidocaine |
| ID | Term |
|---|---|
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D003510 | Cyclohexanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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