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Effectiveness of opioid free anesthesia using Dexmedetomidine to inhibit nociception in abdominal laparoscopic surgery
Abdominal laparoscopic surgery is one of the most common procedures worldwide, commonly facilitated with opioid balanced anesthesia or regional anesthesia. Despite being a controversy, there are issues that suggest opioid to have an influence in tumor recurrence. The investigators performed general anesthesia without opioid in laparoscopic abdominal surgery, and compared the hemodynamic instability, total consumption of fentanyl rescue, qNOX score, Ephedrine intraoperative, and Numerical Rating Scale.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Opioid free anesthesia | Experimental | Patients in this group are given a combination of Dexmedetomidine, Lidocaine, Propofol, Sevoflurane, Rocuronium for induction and maintenance of general anesthesia. They are given rescue analgesia (fentanyl) when required, and Ephedrine as needed. Patients were monitored using standard ASA monitoring and Connox. Post operative pain score was assessed with NRS |
|
| Opioid balanced anesthesia | Active Comparator | Patients in this group are given a combination of Opioid (Fentanyl), Lidocaine, Propofol, Sevoflurane, Rocuronium for induction and maintenance of general anesthesia. They are given Ephedrine as needed. Patients were monitored using standard ASA monitoring and Connox. Post operative pain score was assessed with NRS |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmedetomidine | Drug | OFA |
| |
| Fentanyl |
| Measure | Description | Time Frame |
|---|---|---|
| Blood pressure | blood pressure, both systolic and diastolic measured with non invasive blood pressure monitoring | Intraoperative |
| Heart rate | Heart rate | Intraoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Total consumption of Opioid | Total consumption of fentanyl as rescue analgesia in mcg | Intraoperative |
| quantium nociception index (qNOX) | qNox score is measured at specific time points, available from Conox monitor measurement since the start of the procedure. Higher value indicates more nociception experienced by the patient (0-100) |
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Inclusion criteria
Exclusion Criteria:
Drop out Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cipto Mangunkusumo Cental National Hospital | Jakarta | DKI Jakarta | 10430 | Indonesia |
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| ID | Term |
|---|---|
| D020927 | Dexmedetomidine |
| D005283 | Fentanyl |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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Participants are randomized into two groups for control (opioid balanced anesthesia) or intervention (opioid free anesthesia)
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| Drug |
Given as analgesia in opioid balanced anesthesia (control) group |
|
| Intraoperative |
| Ephedrine | Total consumption of ephedrine to increase heart rate and blood pressure in mg | intraoperative |
| Pain score | Numerical rating scale 0-10 is used to quantify pain score postoperatively, with higher value indicating more pain experienced by the patient | 24 hour |
| D010880 |
| Piperidines |