FEASIBILITY AND EFFECTIVENESS OF GENERAL ANESTHESIA WITH OPIOIDS VERSUS OPIOID-FREE ANESTHESIA PLUS TRANSVERSUS ABDOMINIS PLANE BLOCK ON POSTOPERATIVE OUTCOMES AFTER MINI GASTRIC BYPASS SURGERY

Opioid-free anesthesia (OFA) is increasingly used at present in surgical practice by many hospitals as a new and very promising anesthesiologic regimen. This study aimed to compare the efficacy of standard general anesthesia with opioids with so-called opioid-free anesthesia on postoperative outcomes of patients who underwent gastric bypass surgery. This randomized, single-blind clinical study enrolled 103 patients scheduled for elective gastric bypass surgery. They were assigned randomly to receive either general anesthesia without opioids plus transversus abdominis plane (TAP) block (Group 1: 53 patients) or general anesthesia with opioids (Group 2: 50 patients). 21.4% (22/103) males and 78.6% (81/103) females were operated. The average age of patients was 40.9 and the average BMI - 48.4. Patients from both groups (patients who received general anesthesia + TAP and patients who received general anesthesia with opioids) were assessed for postoperative pain at rest using a 0-to-10 visual analog pain scale (0 = no pain, 5 = moderate pain, and 10 = the most severe pain possible). In group 1 - 34% (18/53) of patients did not receive any medication against pain and 66% (35/53) received Dexalgin Inject 25mg/ml 2 ml. There was no need in opioids. In group 2 - 10% (5/50) of patients did not receive any medication against pain, 38% (19/50) received Dexalgin Inject 25mg/ml 2 ml and 52% (26/50) received Dexalgin Inject 25mg/ml 2 ml + Promedol 20mg/ml 1ml. Type of anesthesia is a significant predictor of postoperative outcomes, such as pain intensity, extubation time, intensive care stay, and hospital length of stay in patients undergoing gastric bypass surgery. Patients, who received (OFA) plus (TAP) block had better pain control than those who received general anesthesia with opioids. No opioids were used in group 1. In addition, the duration of hospital stay in group 1 was shorter, and the average cost for postoperative hospital stay was 2.39 times lower than in group 2. OFA can be used as a reliable and effective anesthesiologic technique in patients scheduled for bariatric surgery.