Safety and effectiveness of opioid-free anesthesia in thoracoscopic surgery: a propensity-score matching analysis

Background: The aim of this study was to observe the effect of opioid-free anesthesia (OFA) on intraoperative hemodynamics and postoperative analgesia in thoracoscopic surgery. Methods: : A total of 101 thoracoscopic surgery patients who received the OFA technique were compared with 101 thoracoscopic surgery patients who received standard opioid-containing anesthesia(SOA),. Heart rate (HR) and mean arterial blood pressure (MAP) were measured before anesthesia induction, immediately after endotracheal intubation, at the beginning of surgery, and 10, 20, and 30 min after the beginning of surgery. Total amount of intraoperative infusion, frequency of vasoactive drug use, morphine ingested via the patient-controlled intravenous analgesia(PCIA) 24 h post-surgery, and visual analogue scale (VAS) scores at rest and activity on the first day after surgery were analyzed. Results: : There was no significant difference in intraoperative HR between the two groups (F=0.889, P=0.347); however, there was significant difference in intraoperative MAP (F=16.709, P<0.001), which was lower in SOA patients than in OFA patients. The frequency of vasoactive drug use and the amount of infusion was less in OFA patients (P=0.001). The amount of morphine used by the PCIA 24 h after surgery was significantly lower in OFA patients (OFA, 1.8 [0, 4.8] mg vs. STD, 3.6 [0.6, 23] mg, P<0.001). There was no significant difference in VAS scores at rest (P=0.745) or during activity (P=0.792) on the first day after surgery. Conclusions: : Compared with SOA, OFA can effectively maintain the stability of intraoperative MAP, reduce the incidence of hypotension, and effectively reduce the consumption of opioids after surgery.