The investigator will examine the effects of opioid free anesthesia in patients undergoing laparoscopic gastrectomy. The investigator expect that opioid free anesthesia will reduce postoperative pain and opioid consumption. And investigator will analyze the association between postoperative pain and patient's underlying psychological characteristics and pain sensitivity. The investigator anticipate that psychological characteristics and pain sensitivity may be realted to postoperative pain and opioid consumption.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
120
Dexmedetomidine and lidocaine are administered during anesthesia, and opioid is not used. For induction, 1 μg/kg of Dexmedetomidine is administered over 10 minutes and 1mg/kg of lidocaine is administered intavenously (bolus). This is followed by continuous intravenous infusion of dexmedetomidine at a rate of 0.2-0.7 μg/kg/h and infusion of lidocaine at the rate of 1 mg/kg/h.
Remifentanil is infused during anesthesia, and target-controlled infusion (TCI) is performed according to the Minto model. During indcution of anestheisa, target concentration of remifentanil is set within 3-5 ng/mL. After intubation, target concentration is adjusted within the range of 2-8 ng/mL.
Gangnam Severance Hospital
Seoul, South Korea
Gangnam Severance Hsopital
Seoul, South Korea
Opioid consumption in postoperative 24hrs
Total opioid dose administered to the patient.
Time frame: 24 hours after surgery
Opioid consumption
Total opioid dose administered to the patient.
Time frame: postoperative 6hours, 12hours, 36hours, 48hours, 3days, 4days, 5days
Time to bowel function recovery (Gas passing time, Fluid intake start time, Soft diet start time)
Time (hours) to first gas passing / starting oral fluid intake / starting soft diet
Time frame: up to 2weeks
Pain score
verbal numerical rating scale 0-10
Time frame: postoperative 6hours, 12hours, 24hours, 36hours, 48hours, 3days, 4days, 5days, 2weeks
Nausea score
verbal numerical rating scale 0-10
Time frame: postoperative 6hours, 12hours, 24hours, 36hours, 48hours, 3days, 4days, 5days
Time to rescue analgesics after surgery
Time (hours) to first rescue analgesics
Time frame: up to 2weeks
Number of vomiting, antiemetic adeministration
Number of vomiting, antiemetic adeministration
Time frame: up to 2weeks
Hemodynamics during surgery
changes in hemodyanamics during surgery
Time frame: during surgery
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QoR-15
Score of QoR-15 questionnaire (Quality of Recovery-15)(Minimum value: 0, Maximum value: 150, higher scores means better.)
Time frame: 1-5 days before surgery, postoperative 1day, postoperative 4day
PCL-5
Score of PCL-5 (Posttraumatic stress disorder Checklist for DSM-5) (Minimum value: 0, Maximum value: 80, higher scores means worse.)
Time frame: postoperative 1week