Opioid-free anesthesia with nociception monitoring in bariatric surgery: Is it effective enough?

Aim: In this study, we aimed to compare the effectiveness of an opioid-free anesthesia method with Nociception Level (NOL) Index monitoring to provide intraoperative analgesia control in laparoscopic bariatric surgeries and its effect on the risk of postoperative nausea and vomiting and the need for antiemetics and analgesics with the opioid-based anesthesia.Material and Methods: Forty patients who underwent laparoscopic bariatric surgery were classified into two groups: those who received opioid-based anesthesia (OA) and those who received opioid-free anesthesia (OFA). Intraoperative NOL index values and additional analgesia requirements were noted. Additional analgesia was administered when the postoperative Visual Analogue Scale (VAS) score was >= 3, an antiemetic drug was administered when the nausea-vomiting score was >= 2, and their amounts were noted.Results: There were no significant differences between the groups in terms of NOL values (p>0.05) +/- 8.52 vs. 74.50 +/- 8.46, 0 vs. 0, p>0.05). Similarities were found between intraoperative and postoperative additional analgesia, VAS score, nausea-vomiting score, and antiemetic drug consumption (p>0.05). Tramadol consumption in the first postoperative 24 hours was significantly higher in the OA group (150.0 +/- 48.7 mg vs. 110.0 +/- 44.7, p= 0.012).Discussion: Opioid-free anesthesia with intraoperative nociception monitoring can be safely applied in bariatric surgery patients.