A Comparative Study Between Analgesic Effect of Opioid Free and Opioid Based Anesthesia in Radical Nephrectomy Surgery

About This Study

Patients undergoing nephrectomy have a high incidence of postoperative pain. In the perioperative period, these patients are often treated with patient-controlled opioids, epidural analgesia, or both. While effective, both of these treatment modalities carry risk, ie, opioids have a side effect profile including pruritus, nausea,vomiting, increase the risk of oversedation and apnea in patients at risk (eg, those with sleep apnea), difficulty in voiding, and ileus. These complications may lead to a prolonged hospital stay. High dose opioids can also cause acute opioid tolerance and hyperalgesia. Epidurals have been associated with hypotension, post dural puncture headaches, changes in management of anticoagulation Opioid free anesthesia (OFA) is a technique in which no intraoperative opioid administered through any route, including systemic, neuraxial, or tissue infiltration.Opioid free anesthesia has many advantages especially avoiding opioid overdose and opioid-induced hyperalgesia. The most important advantage of OFA seems to be the potential improvement of recovery profile in obese patients. OFA depends on combinations of non-opioid agents and adjuncts, including propofol, lidocaine, magnesium, dexmedetomidine, and ketamine to produce anesthesia, and analgesia. Aim of the work our study aim to compare the analgesic effect of OFA and opioid based general anesthesia using pre emptive wound infiltration in patients undergoing open radical nephrectomy surgery. Objectives: 1. To evaluate analgesic effect of each group intra operative {heart rate, and systolic and diastolic blood pressure } 2. To evaluate analgesic effect of each group post operative \[total opioid consumption in 24h postoperative , Postoperative VAS , hemodynamic). 3. To estimate the incidence of early postoperative complication in both groups

Conditions Studied

Interventions

• •pre emptive local anaesthetic wound infiltration

Eligibility

Inclusion Criteria:

1. Gender both males and females
2. ASA Class II
3. Age 18-70 years
4. Patients undergoing open radical nephrectomy

Exclusion Criteria:

1. Allergy to local anesthetic
2. Infection of the skin at the site of local infiltration
3. Cvs problem(ischemic heart disease,arrhythmias{heart block, supraventricular tachyarrhythmia (SVT),atrial fibrillation (AF),multiple extra systole)
4. Liver and renal impairment(elevated liver enzymes (ALT, AST two to three fold), chronic renal failure (CRF) )

Study Locations (1)