Opioid Free Anesthesia on the Quality of Early Recovery

OFA scheme (group T) was given dexamethasone 8mg for anti-inflammatory and antiemetic before operation, flurbiprofen axetil 50mg for preemptive analgesia, and dexmedetomidine was infused under ECG monitoring at an initial rate of 0.5 μ G/kg (more than 10min), then changed to 0.2ug/kg/h, and stopped infusion 20 minutes before operation closure. Before induction, lidocaine (1mg/kg), esketamine (0.5mg/kg), propofol (1-2mg/kg) and rocuronium (0.6mg/kg) were infused slowly, and endotracheal intubation was carried out when the anesthetic was fully effective and the BIS value was about 40. After successful intubation.During the operation, continuous propofol (BIS-guided) plus dexmedetomidine 0.2 μg/kg/h (stopped 20 min before skin closure) plus lidocaine 1 mg/kg/h was used to maintain the depth of anesthesia; The routine anesthesia group (Group C) was induced to give sufentanil 0.3-0.5ug/kg, propofol 1-2mg/kg, rocuronium 0.6mg/kg slowly, and then intubated when the anesthetic was fully effective and the BIS value was about 40. Remifentanil was continuously pumped 0.1-0.2ug/kg during operation min. Total intravenous propofol (BIS guided) plus a continuous remifentanil infusion at 0.1-0.2 μg/kg/min was used to maintain the depth of anesthesia.

Inclusion criteria

• Patients undergoing elective thyroidectomy under general anesthesia
• >18 year old
• The informed consent form has been signed
• American Society of Anesthesiologists (ASA) anesthesia grade I - II

Exclusion criteria

• Long term use of opioids
• Long term use of NSAIDs
• Have a history of psychosis, epilepsy, preoperative anxiety, depression, and emotional management disorders
• Patients with increased gastric contents reflux and respiratory tract aspiration
• Operation time>3h
• Severe liver and kidney insufficiency, cardiac insufficiency, bradycardia with 2 ° II or 3° atrioventricular block
• Those who are allergic to or have contraindications to drugs that may be used in the test
• Those who cannot cooperate with researchers