Opioid-free anaesthesia protocol based on thoracic paravertebral block enhances postoperative recovery after breast cancer surgery: A two-center, prospective, randomized, controlled trial - 16/07/25
, Yuerou Feng a, Xiong Song a, Guanli Luo a, Weiyi Qin a, Xiaofan Lu a, Liquan Zheng a, Haidong Wang c, ⁎⁎ , Yali Lu a, ⁎ , Renchun Lai a, ⁎ Abstract |
Study objective |
To evaluate whether the implementation of an opioid-free anaesthesia (OFA) protocol based on thoracic paravertebral block (TPVB) could improve early postoperative recovery quality in patients undergoing breast cancer surgery. We hypothesized that opioid-free anaesthesia with TPVB would improve the 15-item quality of recovery (QoR-15) at 24 h relative to conventional anaesthesia protocol.
Design |
A prospective, randomized and controlled trial.
Setting |
Sun Yat-Sen University Cancer Center and Gansu Provincial Cancer Hospital.
Patients |
Based on a minimal clinically important difference (MCID) of 6.0 and an assumed standard deviation (SD) of 16 for postoperative QoR-15 score, a total of 252 patients undergoing breast cancer surgery were enrolled.
Interventions |
Patients were allocated to either opioid-based anaesthesia (OA) group or OFA group.
Measurements |
The primary outcome was QoR-15 score at 24 h postoperatively. Secondary outcomes included QoR-15 score at 48 h, numerical rating scale (NRS) pain scores at rest and during activity at PACU, 6, 12, 24, and 48 h postoperatively, postoperative analgesic rescue, the occurrence of adverse effects such as nausea and vomiting, the time to first urination and the length of hospital stay.
Main results |
At 24 h postoperatively, means and standard errors (SE) of QoR-15 score were 139.12 (0.72) in the OFA group significantly higher than those in the OA group 132.48 (0.84) [difference of 6.6, 95 % Confidence Interval (CI), 4.87–8.40, P < 0.001]. The QoR-15 score of OFA [145.31 (0.67)] at 48 h is also higher than that of OA [142.18 (0.88)]. The resting NRS score at 6 h and the active NRS score within 12 h after surgery in the OFA group were significantly lower than those in the OA group (P < 0.001). Fewer patients suffered from postoperative nausea and retching in the OFA group (P < 0.05). There were no statistical differences in the time to first urination and length of stay between OFA and OA groups (P > 0.05).
Conclusion |
OFA based on TPVB improved the postoperative quality of recovery in patients undergoing breast cancer surgery.
Trial registration |
www.chictr.org.cn, Identifier: ChiCTR2300072501, principal investigator: Renchun Lai, date of registration: 2023-06-15.
Clinical trial registration |
ChiCTR2300072501.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Opioid-free anaesthesia can improve postoperative quality of recovery. |
• | Opioid-free anaesthesia can reduce postoperative nausea and retching. |
• | Opioid-free anaesthesia can reduce surgical pain score. |
Keywords : Opioid-free anaesthesia, Thoracic paravertebral block, QoR-15, Breast cancer
Plan
Vol 105
Article 111904- juillet 2025 Retour au numéro
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