dc.contributor.author | Olausson, Alexander | |
dc.date.accessioned | 2024-11-20T08:43:04Z | |
dc.date.available | 2024-11-20T08:43:04Z | |
dc.date.issued | 2024-11-20 | |
dc.identifier.isbn | 978-91-8115-000-1 (PRINT) | |
dc.identifier.isbn | 978-91-8115-001-8 (PDF) | |
dc.identifier.uri | https://hdl.handle.net/2077/83349 | |
dc.description.abstract | Obesity 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.iso | eng | sv |
dc.relation.haspart | 1. 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.13994 | sv |
dc.relation.haspart | 2. 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.2024.100201 | sv |
dc.relation.haspart | 3. 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.haspart | 4. 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.subject | obesity | sv |
dc.subject | bariatric surgery | sv |
dc.subject | opioid-free anaesthesia | sv |
dc.subject | transcutaneous electrical nerve stimulation | sv |
dc.subject | perioperative care | sv |
dc.subject | person-centred care | sv |
dc.title | Prerequisites and effects of an opioid-free anaesthesia pathway in patients undergoing bariatric surgery | sv |
dc.type | text | eng |
dc.type.svep | Doctoral thesis | eng |
dc.gup.mail | alexander.olausson@gu.se | sv |
dc.type.degree | Doctor of Philosophy (Health Care Sciences) | sv |
dc.gup.origin | University of Gothenburg. Sahlgrenska Academy | sv |
dc.gup.department | Institute of Health and Care Sciences | sv |
dc.gup.defenceplace | Fredagen den 13 december, kl 9.00, Hörsal 2119, Hälsovetarbacken, Arvid Wallgrens backe 1, Göteborg | sv |
dc.gup.defencedate | 2024-12-13 | |
dc.gup.dissdb-fakultet | SA | |