Outcomes with Opioid Based Versus Opioid-Free Anesthesia in Cancer Surgery of Head and Neck

Background: Opioid-free anesthesia (OFA) involves a combination of methods aimed at minimizing opioid use perioperatively to mitigate opioid-related adverse effects while preserving patient comfort. This study seeks to evaluate and compare the effects of opioid-free anesthesia (OFA) versus opioid anesthesia (OA) in patients undergoing surgical procedures for head and neck cancer. Materials and Methods: 88 patients scheduled for head and neck cancer surgeries were randomly assigned to two groups: the opioid anesthesia (OA) group and the opioid-free anesthesia (OFA) group (44 each). Patients in the OFA group received intravenous (IV) lignocaine at 1.5 mg/kg, IV dexmedetomidine at 0.5 mcg/kg, and IV ketamine at 0.5 mg/kg. Meanwhile, those in the OA group were administered IV fentanyl at 2 mcg/kg. Hemodynamic parameters were continuously monitored intraoperatively, with post-operative assessments of analgesic use and visual analog scale (VAS) scores for pain conducted over a 24-hour period. Any side effects were also recorded. Results: Hemodynamic stability, VAS scores, and analgesic requirements were similar between the two groups, showing no statistically significant differences. However, the need for propofol was notably reduced in the OFA group. Conclusion: The results of this study indicate that the OFA protocol is a safe, effective, and satisfactory approach that could serve as an alternative to opioid-based anesthesia during induction for patients undergoing head and neck cancer surgeries.