Impact of opioid-sparing anesthesia on hemodynamics,blood glucose and pain in shoulder arthroscopy under the ERAS concept
HU Xinying
XIA Ruina
SHAO Chao
HU Yun
LU Hongxiang
Abstract：Objective To explore the effects of opioid-sparing anesthesia on hemodynamics,blood glucose,pain and adverse reactions in shoulder arthroscopy under the concept of enhanced recovery after surgery(ERAS).Methods A total of 350 patients scheduled for elective arthroscopic shoulder surgery who were admitted from July 2023 to July 2024 were selected and divided into Group A and Group B by random number table method,with 175 patients in each group.Group A was given low-dose opioid-sparing anesthesia,while Group B was given normal-dose opioid anesthesia.Heart rate(HR),mean arterial pressure(MAP)level,and blood glucose concentration at different time points[at1 min before anesthesia(T1),5 min before surgical incision(T2),1 min after surgical incision(T3),30 min after surgical incision(T4),2 h after surgical incision(T5),8 h after surgical incision(T6),24 h after surgical incision(T7),48 h after surgical incision h(T8)],numerical rating scale(NRS)pain score at T5-T8,Riker sedative-agitation score(SAS),Bruggrmann comfort scale(BCS)score,Intraoperative and postoperative related indicators(opioid dosage,duration of operation,intraoperative blood loss,extubation time,time of first off-bed activity,length of hospital stay),and the occurrence of adverse reactions were compared between the two groups.Results HR and MAP of group A at T2-T4 were better than those of group B,the blood glucose at T5-T7 was lower than that of group B,and the NRS pain score at T5-T8 was lower than that of group B(P<0.05).The BCS score of group A at T6-T8 was higher than that of group B,while the SAS score was lower than that of group B(P<0.05).The dosage of opioids in group A was lower than that in group B,the extubation time and the time of the first off-bed activity in group A were earlier than those in group B,and the length of hospital stay in group A was shorter than that in group B(P<0.01).The total incidence of adverse reactions in group A[0.57%(1/175)]was lower than that in group B[5.14%(9/175)](P<0.05).Conclusion Opioid-sparing anesthesia for shoulder arthroscopy under the ERAS concept has a small impact on the hemodynamics of patients,and is conducive to reducing the dosage of opioid drugs during the perioperative period,and alleviating postoperative stress-induced hyperglycemia,hyperalgesia and agitation during the recovery period,with favorable anesthetic comfort,and fewer adverse reactions,thereby accelerating the early postoperative recovery.
Keywords：opioid anesthesiaenhanced recovery after surgeryshoulder arthroscopystress responsehemodynamicspainblood glucose
Publication Date：2025-09-28
Online Publishing Date：2025-10-17(First online date of this platform, not the publication date of the document)
Pages：7( 64-70 )