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VOLUME 10 , ISSUE 1--4 ( January-December, 2024 ) > List of Articles


Opioid-free Anesthetic Mixture for Perioperative Pain Relief in Spine Surgeries: A Prospective Randomized Clinical Study

Sowmya Madihalli Janardhan Iyengar, Shankar Kantharaju, Pala Divyasree

Keywords : Hemodynamic changes, Nonopioid analgesia, Spine surgery

DOI: 10.5005/jp-journals-10045-00247

License: CC BY-NC 4.0

Published Online: 10-05-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background and aim: Patients undergoing spine surgeries experience severe postoperative pain. This study compares an opioid-free anesthesia (OFA) approach with conventional opioid-based anesthesia (OBA) in patients undergoing spine surgery and its impact on perioperative pain, opioid consumption, hemodynamic stability, and adverse effects. Materials and methods: A total of 56 patients undergoing elective spine surgery were randomly assigned into two groups. Group OFA received intravenous 1 gm paracetamol, 2 gm MgSO4, 100 mg lignocaine, 8 mg dexamethasone, and 0.3 mg/kg ketamine in 100 mL normal saline as a mixture over 20 minutes prior to induction. Group OBA received 100 mL saline over 20 minutes. General anesthesia was administered with 2 µg/kg fentanyl diluted to 10 mL in group OBA, and group OFA received 10 mL of normal saline 5 minutes prior to induction. Results: Reduced 24-hour mean visual analog scale (VAS) was seen in the OFA group compared to the OBA group (5.54 vs 5.93) along with significant suppression of heart rate to laryngoscopy, reduced intraoperative fentanyl consumption (3.6 vs 100%), and comparable postoperative tramadol consumption. Conclusion: This nonopioid multimodal regime is a safe and effective method that provides adequate pain relief and opioid-sparing effects.

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