Study of Opioid-Free Versus Opioid-Based Anesthesia-Analgesia in Elective Open Abdominal Aortic Aneurysm Repair and Their Effects on Surgical Stress Response

What this Trial Is About

Open abdominal aortic aneurysm (AAA) repair is a high-risk surgery that causes intense stress responses in the body, including activation of inflammatory processes and immune system changes. This trial evaluates how a new opioid-free anesthesia and analgesia strategy compares to the traditional opioid-based approach in reducing the surgical stress response during elective open AAA repair. The study is a Phase 4 prospective randomized trial that aims to improve patient outcomes by managing the body's reaction to surgery more effectively. The study compares two anesthesia approaches: a multimodal opioid-free anesthesia-analgesia (OFA-A) strategy using drugs like pregabalin, ketamine, dexmedetomidine, lidocaine, dexamethasone, dexketoprofen, paracetamol, and magnesium sulfate, and a conventional opioid-based anesthesia-analgesia (OBA-A) strategy. Both strategies are applied perioperatively during elective open abdominal aortic infrarenal aneurysm repair. The trial investigates whether the OFA-A approach can reduce inflammatory and stress responses compared to the standard opioid-based method. Participants undergo surgery with their assigned anesthesia technique while researchers monitor inflammatory markers such as IL-6, IL-8, IL-10, TNF-a, CRP, cortisol, AVP, and white blood cell count before and after surgery at multiple time points. Hemodynamic stability and fluid requirements are also closely tracked during and after surgery. The study measures these outcomes up to 24 hours postoperatively to assess the surgical stress response and potential benefits of the opioid-free anesthesia method.

Opioid Free Anesthesia-Analgesia Strategy and Surgical Stress in Elective Open Abdominal Aortic Aneurysm Repair