Impact of Opioid-Free Anesthesia-Analgesia Compared to Opioid-Based Anesthesia on Immune Response and Surgical Stress in Lung Cancer Patients Undergoing Elective VATS Lobectomy

What this Trial Is About

Researchers are evaluating the impact of an Opioid-Free Anaesthesia-Analgesia OFA-A strategy compared to a conventional Opioid-Based Anaesthesia-Analgesia OBA-A approach in patients undergoing elective video-assisted thoracoscopic surgery VATS lobectomy for early stage non-small cell lung cancer NSCLC. The study focuses on how these anesthesia methods influence surgical stress response, immune system modulation, and postoperative infections due to the high surgical stress and immunosuppression caused by lobectomy and one-lung ventilation. The trial is a prospective randomized study sponsored by the University of Crete. Two anesthesia strategies will be compared the conventional Opioid-Based method using drugs like midazolam, propofol, fentanyl, morphine, and others, and the Opioid-Free approach which uses a combination of agents including pregabalin, dexmedetomidine, lidocaine, ketamine, magnesium sulphate, and dexamethasone among others. Both include premedication, anesthesia induction and maintenance, wound infiltration, and postoperative analgesia with patient-controlled analgesia pumps using different drug combinations. Rescue therapy with tramadol is available if needed. Participants will undergo various blood tests before surgery, at the end of surgery, and 24 hours after to measure markers of inflammation and immune response, such as interleukins, tumor necrosis factor, C-reactive protein, and white blood cell counts. Hemodynamic stability will be monitored continuously during surgery. Postoperative pain will be assessed daily for three days using multiple pain scales, and pulmonary complications will be tracked for five days. Chronic pain will be evaluated three months after surgery. The total duration of participation includes surgery and follow-up assessments over several months.

Opioid Free Anaesthesia-Analgesia Strategy on Surgical Stress and Immunomodulation in Elective VATS-Lobectomy for NSCLC