Comparison of the effects of opioid-free anesthesia (OFA) and opioid-based anesthesia (OBA) on postoperative analgesia and intraoperative hemodynamics in patients undergoing spine surgery: A prospective randomized double-blind controlled trial.
Saudi journal of anaesthesia January 1, 2024 Ugrani S Rani, Nidhi B Panda, Rajeev Chauhan et al. 11 citations
Opioid-free anesthesia using ketamine and ketofol provided a significantly longer pain-free period after thoracolumbar spine surgery compared to opioid-based anesthesia with fentanyl and propofol. The mean pain-free period was 9.86 hours in the opioid-free group versus 6.93 hours in the opioid-based group. Total fentanyl requirement over 48 hours was considerably lower in the opioid-free group. However, hypertension occurred more often in the opioid-free group (46% of patients), while hypotension was more common in the opioid-based group (43%). Postoperative nausea and vomiting was less frequent with opioid-free anesthesia at 2 and 6 hours. The authors suggest careful titration of drug infusion rates is needed to manage blood pressure differences.