Opiate-free anaesthesia may cut need for pain-killers

Patients undergoing breast cancer surgery need less painkilling medication post-surgery if they have anaesthesia that is free of opioid drugs, researchers have found.
While opioid drugs provide an excellent painkilling effect throughout operations, they also have side-effects, researchers said.
Post-operative complications, such as respiratory depression, post-operative nausea and vomiting, itching, difficulty going to the toilet and bowel obstruction are well known examples of such side-effects, they said.
"Our results show that patients in the non-opiate group require less painkillers, but receive adequate pain relief. Patients require less analgesics 24 hours after a non-opiate anaesthesia than after an opiate anaesthesia," said Sarah Saxena from Jules Bordet Institute in Belgium.

For the study which took place between 2014 and 2015, researchers examined painkiller requirements after patients received opiate anaesthesia and non-opiate anaesthesia.
A randomised controlled trial was conducted, containing two groups each with 33 breast cancer patients undergoing a mastectomy or lumpectomy.

Perioperative non-opiate analgesia was obtained by combining clonidine, ketamine and lidocaine, researchers said.
An extra bolus of ketamine was given if necessary. Opiate analgesia was obtained via a combination of remifentanil infusion, ketamine and lidocaine, they said.
Both groups received intravenous paracetamol and intravenous diclofenac. Patients received a PCA (patient-controlled analgesia) pump for breakthrough pain during the first 24 hours post-operatively.

Clinical characteristics and post-operative piritramide painkiller consumption through the patient controlled pump were assessed during the first 24 hours post-operatively.
The total mean piritramide usage 24 hours post-operatively was 8.1 milligrammes (range 2.0-14.5) in the non-opiate group and 13.1 milligrammes (range 6.0-16.0) in the opioid group. The difference observed was statistically significant, researchers said.