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dc.contributor.authorOlausson, Alexander
dc.date.accessioned2024-11-20T08:43:04Z
dc.date.available2024-11-20T08:43:04Z
dc.date.issued2024-11-20
dc.identifier.isbn978-91-8115-000-1 (PRINT)
dc.identifier.isbn978-91-8115-001-8 (PDF)
dc.identifier.urihttps://hdl.handle.net/2077/83349
dc.description.abstractObesity is an escalating public health concern and bariatric surgery remains the only effective long-term treatment for substantial weight reduction. However, bariatric surgery typically involves opioid use during and after the surgery, which can challenge recovery due to undesirable side effects. Although opioid-free anaesthesia (OFA) is a promising alternative, further research is needed to evaluate its safety and impact on long-term recovery, along with sustained opioid-free approaches for managing postoperative pain. The overall aim of this thesis was to evaluate the prerequisites and effects of an OFA pathway compared to conventional opioid-based care and to identify the prerequisites for integrating a person-centred care approach for patients undergoing laparoscopic bariatric surgery. The thesis includes a systematic review and meta- analysis (Study I), two qualitative interview studies with content analysis (Study II & IV), and a quantitative effect study (Study III). The thesis is based on a randomised controlled trial (RCT) in which the intervention included OFA and transcutaneous electrical nerve stimulation as primary postoperative pain management for patients undergoing laparoscopic bariatric surgery. Study II-IV are based on the same population from the RCT, conducted between May 2019 and November 2023. Study I established the prerequisites for an OFA pathway in various surgical contexts, including laparoscopic bariatric surgery. Meta-analysis results indicated reduced postoperative side effects and opioid consumption without compromising patient safety or pain management, compared with opioid-based anaesthesia. The RCT (Studies II-IV) supported the feasibility of the OFA pathway, with quantitative data revealing reduced opioid consumption and comparable pain and recovery outcomes up to 3 months. Qualitative findings revealed similar patient experiences during the perioperative and recovery periods for up to 1 year. Addressing perioperative challenges by integrating a person-centred care approach into the OFA pathway could improve patient outcomes. Overall, this thesis provides valuable insights to advance perioperative care, presenting a safe and viable alternative to conventional opioid-based perioperative approaches.sv
dc.language.isoengsv
dc.relation.haspart1. Olausson, A., Svensson, C. J., Andréll, P., Jildenstål, P., Thörn, S. E., & Wolf, A. Total opioid-free general anaesthesia can improve postoperative outcomes after surgery, without evidence of adverse effects on patient safety and pain management: A systematic review and meta-analysis. Acta anaesthesiologica Scandinavica, 2022; 66(2), 170–185. https://doi.org/10.1111/aas.13994sv
dc.relation.haspart2. Olausson, A., Angelini, E., Heckemann, B., Andréll, P., Jildenstål, P., Thörn, S. E., & Wolf, A. Patients' perioperative experiences of an opioid-free versus opioid- based care pathway for laparoscopic bariatric surgery: A qualitative study. International Journal of Nursing Studies Advances, 2024; 6, 100201. https://doi.org/10.1016/j.ijnsa.2024.100201sv
dc.relation.haspart3. Olausson, A., Jildenstål, P., Andréll, P., Angelini, E., Stenberg, E., Wallenius, V., Öhrström, H., Thörn, S. E., & Wolf, A. Effects of an opioid-free care pathway versus opioid-based standard care on postoperative pain and postoperative quality of recovery after laparoscopic surgery: A multicentre randomised controlled trial. (Submitted manuscript)sv
dc.relation.haspart4. Olausson, A., Angelini, E., Andréll, P., Heckemann, B., Jildenstål, P., Ovesson, C., Thörn, S. E., Vinglid. J. & Wolf, A. Patients’ experiences of postoperative recovery up to one year after opioid-free or opioid-based bariatric surgery: A qualitative study. (Submitted manuscript)sv
dc.subjectobesitysv
dc.subjectbariatric surgerysv
dc.subjectopioid-free anaesthesiasv
dc.subjecttranscutaneous electrical nerve stimulationsv
dc.subjectperioperative caresv
dc.subjectperson-centred caresv
dc.titlePrerequisites and effects of an opioid-free anaesthesia pathway in patients undergoing bariatric surgerysv
dc.typetexteng
dc.type.svepDoctoral thesiseng
dc.gup.mailalexander.olausson@gu.sesv
dc.type.degreeDoctor of Philosophy (Health Care Sciences)sv
dc.gup.originUniversity of Gothenburg. Sahlgrenska Academysv
dc.gup.departmentInstitute of Health and Care Sciencessv
dc.gup.defenceplaceFredagen den 13 december, kl 9.00, Hörsal 2119, Hälsovetarbacken, Arvid Wallgrens backe 1, Göteborgsv
dc.gup.defencedate2024-12-13
dc.gup.dissdb-fakultetSA


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