Introduction: Opioids have been used as a part of balanced anaesthesia and have known side effects. Opioid Free Analgesia is an emerging technique, based on avoiding intraoperative opioids. Aims: To compare the effectiveness of opioid-free versus opioid based anaesthesia. Methods: This comparative study involved 100 patients undergoing elective laparoscopic cholecystectomy under general anaesthesia with American Society of Anaesthesiologists I or II physical status. Out of 100 patients, 50 received Fentanyl (Group A) while another 50 (Group B) received Ketamine and Lignocaine. Parameters measured and compared were the gender, age, weight, ASA physical status, hemodynamic stability, postoperative pain intensity (VAS) and opioid requirements, as well as side effects. Results: Both groups were comparable with regards to age, gender, weight, American Society of Anaesthesiologists I or II physical status, mean duration of surgery. There was no significant difference between groups hemodynamics at all assessed times (p>0.05) intraoperatively. Visual Analogue Scale pain score in the first 24 hours postoperatively showed that patients in Group A, at all analyzed time points had higher Visual Analogue Scale scores than Group B, but statistically significant difference was confirmed during the first hour (p = 0.001). Seven(14%) in Group A and 5(10%) patients in Group B got intravenous tramadol only once while 5(10%) patients in Group A required twice, which was statistically significant (p=0.05). Intraoperatively, 2 patients (4%) in group A had bradycardia while none in group B, which was statistically insignificant (p=0.153). Postoperatively, nausea was more in group A than Group B i.e. 8% vs 4% (p=0.4). Conclusion: Opioid Free anaesthesia has a better benefit over Opioid anaesthesia with regard to postoperative pain score, opioid consumption and its side effects.
Introduction: Pain during injection of propofol continues to be a major discomfort for patients. Different propofol formulations have been introduced to reduce the incidence of pain. Aims: To know the incidence, severity of pain at induction and post operative amnesic effect of two different formulations of propofol. Methods: This double-blinded comparative study involved randomly selected 100 patients undergoing elective surgery under general anesthesia with physical status score I or II (American Society of Anesthesiologists). Out of 100 patients, 50 received medium and long chain triglyceride Propofol (Group A) while another 50 received nanoemulsion Propofol (Group B) intravenously. Parameters measured and compared were the gender, age, weight, physical status score, pain on injection and postoperative recall of pain during injection of propofol. Results: Both groups were comparable with regards to age, gender, physical status score, mean duration of surgery. The presence of pain during injection with propofol in group A was 76% (38 patients) while 36% (18 patients) in group B which was statistically significant (p =0.0001). Severity of pain was more in group A which was statistically significant in comparison to group B (p=0.0001). The arm withdrawal during the injection of propofol was found more in Group A than Group B, 24% vs 0% (p=0.0002). Recall of pain after 4 hours postoperatively was found in 5 patients of Group A (10%) and 3 patients of Group B (6%) which came out to be statistically insignificant (p=0.715). There was no significant difference between groups regarding heart rate, mean arterial pressure, respiratory rate and arterial hemoglobin oxygenation at all assessed times (p > 0.05) intraoperatively. Conclusion: This study clearly shows the incidence and severity of pain on intravenous administration in nanoemulsion Propofol is significantly less. However, amnestic effect was equally present in both the groups.
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