게시판
| 21KS-038 |
Analgesic efficacy of Opioid-sparing Multimodal Analgesia protocol in Minimally Invasive Surgery for Colorectal Cancer
칠곡경북대학교병원 마취통증의학과
The opioid is a potent analgesic that relieves postoperative pain. But, postoperative opioid use can cause various side effects and delay postoperative recovery.
It is necessary to properly control pain, but reduce the use of opioids after surgery
We performed this study that effectively control pain with administered minimally opioids after surgery.
The patients who received the minimal invasive surgery for colorectal cancer resection, ASA classification I and II, aged 18-75, were randomly divided into PCA group and MMA group.
The PCA group was administered with morphine-based PCA and IV tramadol, and the MMA group was administered with oral pregabalin, local anesthetics, transversus abdominis plane block, and IV tramadol.
The primary outcome was the numeric rating scale (NRS) score for pain at rest 24 h postoperatively.
Ninety-seven patients were included in the intention-to-treat analysis. The protocol completeness was significantly higher in the MMA group than in the PCA group (93.7% vs. 80.2%; p < .001). The mean difference in pain score during rest at 24h was 0.20 (95% CI This result demonstrated the non-inferiority of MMA to PCA at our non-inferiority margin (pared with the PCA group, the median remifentanil dose (996 vs. 654; p <.001) and time in the post-anesthesia care unit (35 vs. 25; p < .001) were significantly less in the MMA group.
We demonstrated that MMA incorporating regional analgesia, perioperative gabapentinoid, and intravenous tramadol was non-inferior to PCIA for patient-reported pain NRS scores and can control pain effectively.
MMA could be used for reducing prescription of the conventional opioids without a significant increase in the prevalence of adverse events.
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