Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial
Abstract Objectives Postoperative nausea and vomiting (PONV) is common after video-assisted thoracic surgery, which may be associated with the use of intraoperative opioids. We tested the hypothesis that balanced opioid-free anesthesia (OFA) might reduce the incidence of PONV after video-assisted th...
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BMC
2025-02-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-02938-x |
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| author | Xiang Yan Chen Liang Jia Jiang Ying Ji An-Shi Wu Chang-Wei Wei |
| author_facet | Xiang Yan Chen Liang Jia Jiang Ying Ji An-Shi Wu Chang-Wei Wei |
| author_sort | Xiang Yan |
| collection | DOAJ |
| description | Abstract Objectives Postoperative nausea and vomiting (PONV) is common after video-assisted thoracic surgery, which may be associated with the use of intraoperative opioids. We tested the hypothesis that balanced opioid-free anesthesia (OFA) might reduce the incidence of PONV after video-assisted thoracic surgery. Methods One hundred and sixty-eight adults undergoing video-assisted thoracic assisted surgery were randomly assigned to receive balanced opioid-free anesthesia or balanced opioid-based anesthesia (OBA). The primary outcome was the incidence of PONV, which was assessed with the Myles’s simplified PONV impact scale during the initial 24 h after surgery. Results Compared with OBA group, the overall incidence of PONV in OFA group was significant reduced (14.6% vs. 30.1%, P = 0.017), and OFA reduced the risk of PONV events within 24 h of surgery (HR, 0.44; 95%CI: 0.22–0.87, P = 0.018). The incidence of other postoperative complications in OFA group was lower than that in OBA group (19.5% vs. 33.7%, P = 0.039). The quality of recovery, distance of 6-minute walk test, pain scores, and 36-item short form survey were comparable at each time points. Conclusion In patients undergoing video-assisted thoracic surgery, the use of balanced OFA anesthesia can help reduce the incidence of PONV events. This anesthetic regimen has shown good feasibility without significantly increasing the patient’s pain score and complications. Clinical trial registration number Clinicaltrials.gov, Identifier: NCT05411159. First posted date: 9 Jun, 2022. |
| format | Article |
| id | doaj-art-76a577b7d32846f290ef11a3c7cc6c75 |
| institution | Kabale University |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj-art-76a577b7d32846f290ef11a3c7cc6c752025-02-09T12:52:00ZengBMCBMC Anesthesiology1471-22532025-02-0125111010.1186/s12871-025-02938-xEffects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trialXiang Yan0Chen Liang1Jia Jiang2Ying Ji3An-Shi Wu4Chang-Wei Wei5Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Medical Statistics, Medieco Group Co., LtdDepartment of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao- Yang Hospital, Capital Medical UniversityDepartment of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical UniversityAbstract Objectives Postoperative nausea and vomiting (PONV) is common after video-assisted thoracic surgery, which may be associated with the use of intraoperative opioids. We tested the hypothesis that balanced opioid-free anesthesia (OFA) might reduce the incidence of PONV after video-assisted thoracic surgery. Methods One hundred and sixty-eight adults undergoing video-assisted thoracic assisted surgery were randomly assigned to receive balanced opioid-free anesthesia or balanced opioid-based anesthesia (OBA). The primary outcome was the incidence of PONV, which was assessed with the Myles’s simplified PONV impact scale during the initial 24 h after surgery. Results Compared with OBA group, the overall incidence of PONV in OFA group was significant reduced (14.6% vs. 30.1%, P = 0.017), and OFA reduced the risk of PONV events within 24 h of surgery (HR, 0.44; 95%CI: 0.22–0.87, P = 0.018). The incidence of other postoperative complications in OFA group was lower than that in OBA group (19.5% vs. 33.7%, P = 0.039). The quality of recovery, distance of 6-minute walk test, pain scores, and 36-item short form survey were comparable at each time points. Conclusion In patients undergoing video-assisted thoracic surgery, the use of balanced OFA anesthesia can help reduce the incidence of PONV events. This anesthetic regimen has shown good feasibility without significantly increasing the patient’s pain score and complications. Clinical trial registration number Clinicaltrials.gov, Identifier: NCT05411159. First posted date: 9 Jun, 2022.https://doi.org/10.1186/s12871-025-02938-xOpioidAnesthesiaNausea and vomitingVideo-assisted thoracic surgeryQuality of recovery6-min walk test |
| spellingShingle | Xiang Yan Chen Liang Jia Jiang Ying Ji An-Shi Wu Chang-Wei Wei Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial BMC Anesthesiology Opioid Anesthesia Nausea and vomiting Video-assisted thoracic surgery Quality of recovery 6-min walk test |
| title | Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial |
| title_full | Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial |
| title_fullStr | Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial |
| title_full_unstemmed | Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial |
| title_short | Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial |
| title_sort | effects of balanced opioid free anesthesia on post operative nausea and vomiting in patients undergoing video assisted thoracic surgery a randomized trial |
| topic | Opioid Anesthesia Nausea and vomiting Video-assisted thoracic surgery Quality of recovery 6-min walk test |
| url | https://doi.org/10.1186/s12871-025-02938-x |
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