Opioid Free Anesthesia-Analgesia Strategy and Surgical Stress in Elective Open Abdominal Aortic Aneurysm Repair
Status:
Recruiting
Trial end date:
2025-10-08
Target enrollment:
Participant gender:
Summary
Open Abdominal Aortic Aneurysm (AAA) repair is a high-risk surgical procedure accompanied by
intense endocrine and metabolic responses to surgical stress, with subsequent activation of
the inflammatory cascade, cytokine and acute-phase protein release, and bone marrow
activation. There is a proven correlation of surgical stress, which patients undergoing open
AAA repair are subjected to, with patient outcome, morbidity/mortality, intensive care unit
stay and overall length of stay. Modern general anesthetic techniques have been revised and
rely on perioperative multimodal anesthetic and analgesic strategies for improved overall
patient outcome. Based on this context of a multimodal anesthetic technique and having taken
into consideration the international "opioid-crisis" epidemic, an Opioid Free
Anesthesia-Analgesia (OFA-A) strategy started to emerge. It is based on the administration of
a variety of anesthetic/analgesic agents with different mechanisms of action, including
immunomodulating and anti-inflammatory effects.
Our basic hypothesis is that the implementation of a perioperative multimodal OFA-A strategy,
involving the administration of pregabalin, ketamine, dexmedetomidine, lidocaine,
dexamethasone, dexketoprofen, paracetamol and magnesium sulphate, will lead to attenuation of
surgical stress response compared to a conventional Opioid-Based Anesthesia-Analgesia (OBA-A)
strategy. Furthermore, the anticipated attenuation of the inflammatory response, is pressumed
to be associated with equal or improved analgesia, compared to a perioperative OBA-A
technique.