Patient preference for intraoperative opioid use and early recovery after noncardiac surgery: protocol for a randomised factorial design trial of opioid-free versus opioid-based anaesthesia (the PERFECT trial)

Yann Gricourt; Nancy M. Boulos; Amelie Delaporte; Brenton Alexander; Stephane Besada; Ryan Bakhit; Aline Toukhtarian; Ido Neuman; Daniel Pearce; Maziar M. Nourian; Arthur Chebishian; Amy Zhou; Janice Boktor; Dylan Mayanja; Tristan Grogan; David Boldt; Maxime Cannesson; Patrice Forget; Alexandre Joosten

doi:10.1016/j.bjao.2025.100420

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Patient preference for intraoperative opioid use and early recovery after noncardiac surgery: protocol for a randomised factorial design trial of opioid-free versus opioid-based anaesthesia (the PERFECT trial)

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Patient preference for intraoperative opioid use and early recovery after noncardiac surgery: protocol for a randomised factorial design trial of opioid-free versus opioid-based anaesthesia (the PERFECT trial)

Yann Gricourt, Nancy M. Boulos, Amelie Delaporte, Brenton Alexander, Stephane Besada, Ryan Bakhit, Aline Toukhtarian, Ido Neuman, Daniel Pearce, Maziar M. Nourian, …

BJA open, Vol.15, pp.100420-100420

01/09/2025

DOI: https://doi.org/10.1016/j.bjao.2025.100420

PMID: 40607110

Résumé

minimally invasive surgical procedures

opioid-free anaesthesia

patient-centred care

quality of recovery

shared decision making

Although opioids are commonly used to relieve pain associated with surgery, they are not consequence free. Moreover, the USA and many western countries are currently experiencing a significant health crisis because of opioid addiction and its related overdose potential. There have been no studies that have evaluated patient preference regarding opioid use and its potential impact on the quality of recovery. The aim of this study is to compare the effect of patient preference on intraoperative opioid use on early postoperative quality of recovery after moderate risk laparoscopic/robotic abdominal surgery. This trial is an interventional, pragmatic, partially randomised factorial trial. Adults (N=240) scheduled for moderate-risk abdominal surgery under laparoscopic/robotic assistance (colorectal, urologic, and gynaecologic) will be allocated into four groups, according to their preference (choice of opioid-free vs opioid-based anaesthesia vs no choice and, if no choice, then the patient is randomised to opioid-based vs opioid-free anaesthesia). Anaesthesia providers and patients who choose their anaesthesia type will be unblinded of the allocation group. The primary endpoint will be the Quality of Recovery-15 score at postoperative day 1. Secondary endpoints will include patient satisfaction, postoperative nausea and vomiting, intraoperative bradycardia, postoperative opioid consumption, postoperative hypoxemia, and health-related quality of life using the EuroQoL 5-Dimension 5-Level (EQ-5D-5L). This trial will provide evidence on whether patient preference on intraoperative opioid use can improve patient quality of recovery after moderate-risk abdominal surgery. NCT06855641. 2.0, 24 February 2025.

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Titre: Patient preference for intraoperative opioid use and early recovery after noncardiac surgery: protocol for a randomised factorial design trial of opioid-free versus opioid-based anaesthesia (the PERFECT trial)
Créateurs - sans rôle: Yann Gricourt - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Nancy M. Boulos - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Amelie Delaporte - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Brenton Alexander - Department of Anesthesiology, UC San Diego School of Medicine, La Jolla, CA, USA
Stephane Besada - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Ryan Bakhit - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Aline Toukhtarian - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Ido Neuman - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Daniel Pearce - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Maziar M. Nourian - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Arthur Chebishian - Department of Anesthesiology, University of California Los Angeles, CA, USA
Amy Zhou - Georgetown University School of Medicine, Washington, DC, USA
Janice Boktor - Department of Anesthesiology, University of California Los Angeles, CA, USA
Dylan Mayanja - Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
Tristan Grogan - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
David Boldt - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Maxime Cannesson - Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, CA, USA
Patrice Forget - IMAGINE UR UM 103, Montpellier University, Anesthesia Critical Care, Emergency and Pain Medicine Division, Nîmes University Hospital, Nîmes, France
Alexandre Joosten - University of California, Los Angeles
Détails de publication: BJA open, Vol.15, pp.100420-100420
Éditeur: Elsevier Ltd
Identifiants: 99155142509311
Unité académique: Initial MAnagement & prevent of acute orGan failures IN critically ill patiEnts - IMAGINE
Langue: English
Type de ressource: Journal article