J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 15, Number 8-9, September 2023, pages 415-422

Opioid Free Total Intravenous Anesthesia With Dexmedetomidine-Esketamine-Lidocaine for Patients Undergoing Lumpectomy

**Table 1.** Characteristics of the Patients
	OFA group (n = 37)	OBA group (n = 37)	P
Data are presented as mean ± SD. OFA: opioid-free anesthesia; OBA: opioid-based anesthesia; SD: standard deviation.
Age (years)	39.78 ± 10.48	39.51 ± 8.37	0.903
Height (cm)	161.95 ± 4.58	159.95 ± 5.10	0.073
Weight (kg)	58.32 ± 8.18	57.97 ± 6.83	0.842
Anesthesia time (min)	46.14 ± 6.96	43.54 ± 6.11	0.092
Surgery time (min)	33.14 ± 7.11	34.41 ± 8.59	0.491
Blood loss (mL)	8.27 ± 3.36	9.24 ± 3.36	0.218

Table 1. Characteristics of the Patients

OFA group (n = 37)

OBA group (n = 37)

Data are presented as mean ± SD. OFA: opioid-free anesthesia; OBA: opioid-based anesthesia; SD: standard deviation.

Age (years)

39.78 ± 10.48

39.51 ± 8.37

0.903

Height (cm)

161.95 ± 4.58

159.95 ± 5.10

0.073

Weight (kg)

58.32 ± 8.18

57.97 ± 6.83

0.842

Anesthesia time (min)

46.14 ± 6.96

43.54 ± 6.11

0.092

Surgery time (min)

33.14 ± 7.11

34.41 ± 8.59

0.491

Blood loss (mL)

8.27 ± 3.36

9.24 ± 3.36

0.218

**Table 2.** Postoperative Analgesia-Related Variables
	OFA group (n = 37)	OBA group (n = 37)	P
Data are presented as number (%), mean ± SD, or median (IQR). OFA: opioid-free anesthesia; OBA: opioid-based anesthesia; IQR: interquartile range; SD: standard deviation; VAS: visual analogue scale.
Rescue analgesic, n (%)	37 (100)	37 (100)
Time to first rescue analgesic (h)	7.40 ± 0.92	6.18 ± 1.00	0.000
Postoperative VAS, median (IQR)
2 h	1 (1 - 2)	1 (0 - 1)	0.067
12 h	2 (1 - 2)	1 (0 - 1)	0.094
24 h	1 (0 - 1)	0 (0 - 1)	0.071

Table 2. Postoperative Analgesia-Related Variables

OFA group (n = 37)

OBA group (n = 37)

Data are presented as number (%), mean ± SD, or median (IQR). OFA: opioid-free anesthesia; OBA: opioid-based anesthesia; IQR: interquartile range; SD: standard deviation; VAS: visual analogue scale.

Rescue analgesic, n (%)

37 (100)

Time to first rescue analgesic (h)

7.40 ± 0.92

6.18 ± 1.00

0.000

Postoperative VAS, median (IQR)

2 h

1 (1 - 2)

1 (0 - 1)

0.067

12 h

2 (1 - 2)

1 (0 - 1)

0.094

24 h

1 (0 - 1)

0 (0 - 1)

0.071

**Table 3.** Intraoperative Hemodynamics and Drugs Consumption
	OFA group (n = 37)	OBA group (n = 37)	P
Values are presented as number (%) or mean ± SD. OFA: opioid-free anesthesia; OBA: opioid-based anesthesia; SD: standard deviation.
Hemodynamics and related variables
Hypotension, n (%)	2 (5)	14 (38)	0.001
Hypertension, n (%)	0 (0)	0 (0)
Bradycardia, n (%)	3 (8)	12 (32)	0.019
Atropine, n (%)	3 (8)	12 (32)	0.019
Ephedrine, n (%)	2 (5)	14 (38)	0.001
Urapidil, n (%)	0 (0)	0 (0)
Drugs consumption
Propofol (mg)	257.2 ± 52.5	278.1 ± 57.6	0.107
Sufentanil (µg)	-	44.2 ± 5.4	-
Remifentanil (µg)	-	10.2 ± 3.0	-
Dexmedetomidine (µg)	40.5 ± 6.1	-	-
Esketamine (mg)	26.2 ± 4.1	-	-
Lidocaine (mg)	126.9 ± 18.2	-	-
Ondansetron, n (%)	2 (5)	13 (35)	0.003

Table 3. Intraoperative Hemodynamics and Drugs Consumption

OFA group (n = 37)

OBA group (n = 37)

Values are presented as number (%) or mean ± SD. OFA: opioid-free anesthesia; OBA: opioid-based anesthesia; SD: standard deviation.

Hemodynamics and related variables

Hypotension, n (%)

2 (5)

14 (38)

0.001

Hypertension, n (%)

0 (0)

Bradycardia, n (%)

3 (8)

12 (32)

0.019

Atropine, n (%)

3 (8)

12 (32)

0.019

Ephedrine, n (%)

2 (5)

14 (38)

0.001

Urapidil, n (%)

0 (0)

Drugs consumption

Propofol (mg)

257.2 ± 52.5

278.1 ± 57.6

0.107

Sufentanil (µg)

44.2 ± 5.4

Remifentanil (µg)

10.2 ± 3.0

Dexmedetomidine (µg)

40.5 ± 6.1

Esketamine (mg)

26.2 ± 4.1

Lidocaine (mg)

126.9 ± 18.2

Ondansetron, n (%)

2 (5)

13 (35)

0.003

**Table 4.** Recovery Quality, Postoperative Adverse Events, and Satisfaction Score
Variables	OFA group (n = 37)	OBA group (n = 37)	P
Values are presented as mean ± SD , number (%) or median (IQR). OFA: opioid-free anesthesia; OBA: opioid-based anesthesia; PONV: postoperative nausea or vomiting; POD: postoperative delirium; IQR: interquartile range; SD: standard deviation.
Recovery quality
Awakening time (min)	7.14 ± 2.63	4.54 ± 1.14	0.000
Recovery time of orientation (min)	11.76 ± 3.15	6.92 ± 1.19	0.000
Postoperative adverse events
PONV, n (%)	4 (11)	19 (51)	0.000
Increased oral secretion, n (%)	5 (14)	3 (8)	0.711
POD, n (%)	0 (0)	0 (0)
Dizziness, n (%)	10 (27)	6 (16)	0.398
Satisfaction score, median (IQR)	9 (8 - 9)	7 (7 - 8)	0.000

Table 4. Recovery Quality, Postoperative Adverse Events, and Satisfaction Score

Variables

OFA group (n = 37)

OBA group (n = 37)

Values are presented as mean ± SD , number (%) or median (IQR). OFA: opioid-free anesthesia; OBA: opioid-based anesthesia; PONV: postoperative nausea or vomiting; POD: postoperative delirium; IQR: interquartile range; SD: standard deviation.

Recovery quality

Awakening time (min)

7.14 ± 2.63

4.54 ± 1.14

0.000

Recovery time of orientation (min)

11.76 ± 3.15

6.92 ± 1.19

0.000

Postoperative adverse events

PONV, n (%)

4 (11)

19 (51)

0.000

Increased oral secretion, n (%)

5 (14)

3 (8)

0.711

POD, n (%)

0 (0)

Dizziness, n (%)

10 (27)

6 (16)

0.398

Satisfaction score, median (IQR)

9 (8 - 9)

7 (7 - 8)

0.000