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Master Thesis

Évaluation de la qualité du rétablissement après chirurgie du rachis sous anesthésie générale sans ou avec opiacés : une étude observationnelle

Abstract : Background: Patients scheduled for spinal surgery have several risk factors for severe acute postoperative pain. "Opioid-free anesthesia" (OFA), using non-opioid agents with analgesics and/or anti-hyperalgesic properties like dexmedetomidine, ketamine, magnesium sulfate and lidocaine may benefit to this patients and hasten their recovery. This prospective observational study assessed the quality of recovery after elective spinal surgery performed under usual opioid-based anesthesia vs OFA, using the QoR-15 score. Methods: Consecutive adult patients undergoing elective spinal surgery were included. The choice of anesthesia technique was left at the discretion of the anesthesiologist in charge of the patient either OFA according to an institutionnal protocol or regular opioid-based anesthesia. QoR-15 questionnaire was recorded at postoperative day 1 and compared to preoperative score. Other perioperative outcomes were assessed like pain scores, postoperative nausea and vomiting. Results: Sixty-six patients were included, 35 received OFA and 31 received opioid anesthesia. Compared with preoperative score, postoperative QoR-15 was significantly decreased in opioid anesthesia group (- 6.73 %; -17.14 to -0.75%; p = 0.018) in contrary to OFA group (+6.00 %; -14.79 to +25.64%; p = 0.335). Despite higher preoperative risk factors, pain at rest and maximal pain at 24 h (p = 0.008) as well as postoperative nausea and vomiting (p<0.001) were less severe in OFA group while postoperative mood was enhanced. Conclusions: The present study shows that patients undergoing elective spinal surgery may benefit from Opioid-Free Anesthesia in terms of early recovery, less postoperative pain and better postoperative nausea and vomiting control.
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Submitted on : Thursday, November 28, 2019 - 6:08:58 PM
Last modification on : Tuesday, December 3, 2019 - 1:23:40 AM
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Elsa Balutet. Évaluation de la qualité du rétablissement après chirurgie du rachis sous anesthésie générale sans ou avec opiacés : une étude observationnelle. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02385455⟩



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