Non-Inferior Efficiency of Opiod-Free Analgesia Support Among Colorectal Cancer Patients During and After Surgical Treatment: Evidences of Open-Label Trial

Abstract

Abstract Objective of the research was to evaluate an impact of non-opioid anesthetic support during and after surgical treatment of colorectal cancer patients on postoperative rehabilitation results. Considering used inclusion and exclusion criteria primary study sample was formed of 50 patients aged 42-83 years (mean age value – 51.2±5.2 years). Based on planned analgesia support during and after operative intervention primary study sample was divided into study and control groups, consisting of 25 subjects each. Study group received opioid-free analgesia support, while control group was supported with opioid-associated protocol of analgesia. Statistically significant difference considering NRS pain scores between study and control group was noted at the 1st (p < 0.05) and 2nd day (p < 0.05) after surgery, while at the day of surgery and at 3rd and 5th day of monitoring such difference was not statistically argumented (р > 0.05). Restitution of bowel peristalsis among study group patients was noted after mean of 1.5±0.4 days, while within control group after mean of 2.9±0.5 days, which was statistically faster considering distribution pattern specifics among all study cohort (p < 0.05). Post-operative hospital stay among study and control group demonstrated analogical trend: 6.4±0.9 days vs. 9.9±0.2 days (p < 0.05). Considering limitations associated with open-label design of provided study it could be resumed that non-opioid postoperative anesthetic approach provides non-inferior effect on rehabilitation efficiency of colorectal cancer patients in terms of post-operative NRS scores, blood pressure parameters, frequency of nausea and vomiting occurrence, peristalsis recovery and duration of hospital stay. Based on the prospective benefits for multimodal non-opioid anesthetic support within the context of influencing different elements of pain pathogenesis, such approach and its modalities should be considered for the future risk/cost/benefit verification during complex assay of colorectal cancer treatment outcomes. Clinical article (J Int Dent Med Res 2021; 14(1): 426-434) Keywords: Multimodal analgesia, opioid-free analgesia, colorectal cancer, open-label trial. Received date: 05 October 2020 Accept date: 29 December 2020