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2. Comparison Between Non-Opioid Versus Opioid Analgesia in Neuro-Surgery
Jawad Hameed, Amjid Ali, Muhammad Sheharyar Ashraf, Abid Haleem Khattak, Ahmad Ali and Haseeba Naeem
ABSTRACT
Objective: To compare effect of opioids and non-opioids pain management protocol in patients underwent neurosurgical procedure.
Study Design: Randomized controlled trial study
Place and Duration of Study: This study was conducted at the Anesthesia department of Lady Reading Hospital, Peshawar, from January 2023 to June 2023.
Methods: A total of 200 patients were enrolled in study and divided into two groups 112 in opioid group and 88 in non-opioid group by simple randomization method. In opioid group patient were given oral hydrocodone and intravenous morphine. In non-opioid group patient s were given NSAIDs. Preoperative variables, including body mass index, age of patients, gender, history of prior surgeries and opioid use and the any medical comorbidities such as hypertension, diabetes mellitus, anxiety and depression. Postoperative data comprised postoperative hemorrhage/bleeding, postoperative pain scores and length of stay.
Results: Morphine equivalent units opioid group was greater than the non opioids group at 6, 12 and 24 hours, (p<0.001). According to primary outcomes, the pain at 6, 12 and 24 hours in opioid patients was 4.04±0.42, 3.65±0.22 and 3.63±0.30, respectively. The pain at 6, 12 and 24 hours in non opioid patients was 3.13±0.55, 3.11±0.18 and 2.63±0.28, respectively.
Conclusion: Non-opioid medications were found to significantly reduce pain compared to opioids, and there were no observed increases in hemorrhagic complications in the non-opioid group. Non-opioid medications may be a viable alternative for managing postoperative pain in neurosurgery patients, potentially with fewer associated complications.
Key Words: Neurosurgery, Pain management, Opioids, Non opioids, Pain score, Post-operative hemorrhage