Assessing the clinical advantage of opioid-reduced anesthesia in thoracoscopic sympathectomy: A prospective randomized controlled trial

Abstract Background: Opioid-reduced multimodal analgesia has been clinically used for years to reduce perioperative complications related to opioid drugs. We aimed to assess the clinical effects of opioid-reduced anesthesia during thoracoscopic sympathectomy. Methods: Surgical patients (n=151) with palmar hyperhidrosis were randomly divided into a control group (Group C, 73 patients) and a weak opioid group (Group W, 78 patients). All patients were administered general anesthesia using a laryngeal mask. In Group C, the patients were anesthetized with propofol, fentanyl, and cisatracurium, and mechanical ventilation was used during the operation. In Group W, the patients received propofol, dezocine, and dexmedetomidine (DEX), and spontaneous breathing was maintained during surgery. Perioperative complications related to opioids include hypotension, bradycardia, hypertension, tachycardia, hypoxemia, nausea, vomiting, urine retention, itching, and dizziness; vital signs, blood gas index, visual analog scale (VAS) score, and other adverse events; patient satisfaction between groups were also recorded. Results: Perioperative complications related to opioids were similar between groups. There were no significant differences in the type of perioperative sedation, analgesia index, respiratory and circulatory indicators, blood gas analysis, postoperative VAS scores, adverse reactions, propofol dosage, postoperative recovery time, and patient satisfaction (P > 0.05). Conclusions: In minimally invasive surgeries such as thoracoscopic sympathectomy, opioid-reduced anesthesia was safe and effective; however, this method did not show clinical advantages. Trial registration Chinese Clinical Trial Register: ChiCTR2100055005, on December 30, 2021.