What are the effects of a combination of lidocaine and dexmedetomidine on the recovery quality after gynecological laparoscopy compared to standard general anesthesia?

Module 6 Article Summary

Jenna Horgan

St Thomas University

NUR 416

Professor Henriquez

February 27, 2022

Study Background

The routine use of opioids during anesthesia in laparoscopy is contributing to the opioid crisis. In recent years opioid-free anesthesia (OFA) has been embraced using dexmedetomidine for surgeries like laparoscopic cholecystectomy (Mulier, 2019). Risks of operative pain and nausea are high when using OFA, posing risks of delayed recovery. The quality of Recovery -40 (QoR-40) questionnaires assesses recovery from anesthesia, and many studies have used it to investigate recovery. However, no study exists about using QoR-40to to determine better effects of OFA than general anesthesia (Song et al., 2021).

Study Type

A prospective clinical controlled trial was used, and it involved patients who received OFA (either lidocaine or dexmedetomidine). The participants were patients between 20-65 years planned for gynecological laparoscopy and received patient-controlled analgesia (Song et al., 2021). The exclusion criteria include patients with pregnancy, hypotension, emergency surgery and refusal of study participation. The participants randomly received standard general anesthesia for the control group or OFA at a 1.1 ratio allocation, and the nurses in the care unit were unaware of the group allocation. The laparoscopy was performed with video guidance, and the patient was constantly monitored for pain.

Purpose

The study aim was to examine the effects of opioid-free anesthesia using lidocaine and dexmedetomidine on recovery from gynecological laparoscopy. The other objective was to determine the feasibility of opioid-free anesthesia (OFA) for gynecological laparoscopy (Song et al., 2021).

Research Questions

The research questions include:

· Does OFA during the postoperative period improve clinical outcomes like shivering and postoperative pain, which might contribute to better recovery?

· What are the effects of a combination of lidocaine and dexmedetomidine on the recovery quality after gynecological laparoscopy compared to standard general anesthesia?

Conclusion

The study provides clinical and scientific evidence on the feasibility of opioid-free anesthesia in gynecological laparoscopy. The information is suitable for nurses, anesthetists and surgeons doing gynecological laparoscopy, as the need for OFA to deal with the opioid crisis keep increasing.

References

Mulier, J. P. (2019). Is opioid-free general anesthesia for breast and gynecological surgery a viable option?. Current Opinion in Anesthesiology, 32(3), 257-262. https://journals.lww.com/co-anesthesiology/Abstract/2019/06000/Is_opioid_free_general_anesthesia_for_breast_and.2.aspx

Song, J. Y., Choi, H., Chae, M., Ko, J., & Moon, Y. E. (2021). The effect of opioid-free anesthesia on the quality of recovery after gynecological laparoscopy: study protocol for a prospective randomized controlled trial. Trials, 22(1), 1-8. https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-021-05166-z