Clinical trials

This study will compare opioid-free anesthesia and opioid-based anesthesia in adult euthyroid patients undergoing elective thyroidectomy. Opioid-based anesthesia is commonly used during surgery, but opioids may be associated with adverse effects such as nausea, vomiting, respiratory depression, hyperalgesia, and increased postoperative opioid use. Opioid-free anesthesia uses non-opioid medications as part of a multimodal strategy to provide intraoperative analgesia. The main aim of this prospective randomized study is to evaluate whether opioid-free anesthesia changes the perioperative oxidative stress response compared with opioid-based anesthesia. Oxidative stress will be assessed using serum biomarkers, including native thiol, total thiol, disulfide, total antioxidant status, total oxidant status, and oxidative stress index. Eligible patients will be randomly assigned to receive either opioid-free anesthesia or fentanyl-based opioid anesthesia. Blood samples will be collected before anesthesia induction, 30 minutes after extubation, and 24 hours after surgery. The study will also compare postoperative pain scores, rescue analgesic requirement, postoperative nausea and vomiting, recovery characteristics, and intraoperative hemodynamic variables between the two anesthesia strategies.

The Systemic Immuno-Inflammation Index (SII) is a ratio derived from complete blood count parameters (neutrophils, lymphocytes, platelets) and is a non-invasive and easily calculable biomarker. The SIPI effectively reflects both local and systemic inflammatory responses in the human body. It has been used to predict and evaluate the prognosis of various solid tumors such as gastric cancer, non-small cell lung cancer, and colorectal cancer. Furthermore, the SIPI has been shown to have significant prognostic value in cardiovascular and cerebrovascular diseases. In this study, the SIPI will be calculated using laboratory data at the time of admission to the intensive care unit, and the relationship between the obtained values and the 30-day mortality status of the patients will be analyzed.