Opioid-Free Anesthesia Leads to Less Pain Medication Use After Breast Cancer Surgery

After breast cancer surgery, patients who received non-opiate analgesia used less painkilling medication than patients who received opiate analgesia.

In a recent study, researchers found that patients needed less pain medication after breast cancer surgery if they were administered opioid-free anesthesia.

Although opioids can control pain throughout operation, they can also cause post-operative complications such as respiratory depression, post-operative nausea, vomiting, itching, constipation, and bowel obstruction, according to a study presented at Euroanaesthesia 2016.

The researchers included 2 groups of 33 patients undergoing a mastectomy or lumpectomy. The groups either received opiate anesthesia or non-opiate anesthesia.

Researchers combined clonidine, ketamine, and lidocaine to create the non-opiate analgesia. Opiate analgesia was created by combining a remifentanil infusion, ketamine, and lidocaine.

Both groups received intravenous paracetamol and intravenous diclofenac. Patients also received a patient-controlled analgesia (PCA) pump for the first 24 hours after surgery.

Researchers found that total painkiller consumption through the PCA pump during the first 24 hours was an average of 8.1-mg in the non-opiate group. In the opioid group, the average was 13.1-mg for the first 24 hours.

According to the study, researchers found this difference to be statistically significant.

"Our results show that patients in the non-opiate group require less painkillers, but receive adequate pain relief. Patients require less analgesics 24 hours after a non-opiate anesthesia than after an opiate anesthesia,” concluded lead researcher Dr Sarah Saxman."This study shows a possible interesting benefit of this type of approach, which needs to be confirmed in further studies. Non-opiate anesthesia in breast cancer surgery might avoid several opiate-related side effects such as post-operative nausea and vomiting. It might also reduce cancer recurrence. However, it is too early to recommend non-opiate anesthesia to all breast cancer patients. We will be doing further research to confirm and extend our findings."