Opioid-Free Anesthesia Versus Opioid Based Anesthesia For Adolescent Idiopathic Scoliosis

Summary

Opioid-free anesthesia (OFA) is a multimodal analgesic approach designed to eliminate the intraoperative use of systemic, neuraxial, or intracavitary opioids. This technique employs a combination of antinociceptive agents targeting various pathways within the central and peripheral nervous systems to achieve effective analgesia. Dexmedetomidine (DEX), a highly selective α2-adrenoreceptor agonist, is a centrally acting non-opioid agent increasingly utilized in clinical practice for its antinociceptive and anxiolytic properties. Only a few prospective randomized controlled trials have specifically examined the postoperative analgesic efficacy of intraoperative dexmedetomidine infusion in patients undergoing spinal surgery, with limited data focusing on this as a primary endpoint. Importantly, no clinical studies have investigated its analgesic impact in patients undergoing spinal surgery under general anesthesia.

Timeline

Start

2026-01-30

Primary completion

2027-01-30

Completion

2027-01-31

Publications

• Results Aujla KS, Kaur M, Gupta R, Singh S, Bhanupreet, Tavleen. A Study to Compare the Quality of Surgical Field Using Total Intravenous Anesthesia (with Propofol) versus Inhalational Anesthesia (with Isoflurane) for Functional Endoscopic Sinus Surgeries. Anesth Essays Res. 2017 Jul-Sep;11(3):606-610. doi: 10.4103/0259-1162.206858.
• Results Ghorbani J, Arastou S, Safavi Naeini A, Raad N, Karimi Galougahi M, Jahangirifard A, Akbari Dilmaghani N. Comparing the Effect of Oral Clonidine and Tranexamic Acid on Bleeding and Surgical Field Quality during Functional Endoscopic Sinus Surgery. Iran J Otorhinolaryngol. 2018 Sep;30(100):255-260.
• Results Lin YM, Yu C, Xian GZ. Calculation methods for intraoperative blood loss: a literature review. BMC Surg. 2024 Dec 20;24(1):394. doi: 10.1186/s12893-024-02699-3.
• Results Pipat Saeyup, Chanon Thanaboriboon. Anesthetic Management and Role of Dexmedetomidine During Intraoperative Wake Up Test in Juvenile Idiopathic Scoliosis Correction Surgery: A Case Report. International Journal of Anesthesia and Clinical Medicine. 2019; 7(1): 27-30 Doi: 10.11648/j.ijacm.20190701.15
• Results Soffin EM, Wetmore DS, Beckman JD, Sheha ED, Vaishnav AS, Albert TJ, Gang CH, Qureshi SA. Opioid-free anesthesia within an enhanced recovery after surgery pathway for minimally invasive lumbar spine surgery: a retrospective matched cohort study. Neurosurg Focus. 2019 Apr 1;46(4):E8. doi: 10.3171/2019.1.FOCUS18645.
• Results Catalca S, Ozmete O, Berk N, Civi S, Durdag E, Incekas C, Ozyilkan NB. Does dexmedetomidine infusion reduce the postoperative analgesic need in lumbar disc surgery? Turk J Med Sci. 2025 Mar 24;55(2):470-481. doi: 10.55730/1300-0144.5991. eCollection 2025.
• Results Rani US, Panda NB, Chauhan R, Mahajan S, Kaloria N, Tripathi M. Comparison of the effects of opioid-free anesthesia (OFA) and opioid-based anesthesia (OBA) on postoperative analgesia and intraoperative hemodynamics in patients undergoing spine surgery: A prospective randomized double-blind controlled trial. Saudi J Anaesth. 2024 Apr-Jun;18(2):173-180. doi: 10.4103/sja.sja_341_23. Epub 2024 Mar 14.
• Results Moustafa AM, Negmi HH, Rabie ME. The combined effect of ketamine and remifentanil infusions as total intravenous anesthesia for scoliosis surgery in children. Middle East J Anaesthesiol. 2008 Jun;19(5):1151-68.
• Results 1- Ferschl M, Shibata G, Wong J. New Surgical Approaches to Scoliosis Repair in Pediatric Patients Implications for Anesthetic Management. Current Anesthesiology Reports 2024; 14:475-83. doi.org/10.1007/s40140-024-00641-0

Drugs

Indications

No indication recorded.