Opioid-Free Versus Opioid-Based Anesthesia for Quality of Recovery Following Laparoscopic Hysterectomy: A Randomized Controlled Non-Inferiority Trial - PubMed
6 hours ago
- #PONV reduction
- #opioid-free anesthesia
- #laparoscopic hysterectomy
- The study compared opioid-free anesthesia (dexmedetomidine/esketamine) with opioid-based anesthesia (sufentanil/remifentanil) in 110 women undergoing laparoscopic hysterectomy.
- Primary outcome was recovery quality at 24 hours, measured using the QoR-15 questionnaire, with non-inferiority defined as a difference of less than 6 points.
- Opioid-free anesthesia showed non-inferior QoR-15 scores (median 123 vs. 121 for opioid-based) and a median difference of 2.0 points (95% CI -1.0 to 4.0, p < 0.001).
- Postoperative morphine consumption was similar between groups (8 mg vs. 10 mg, p = 0.315).
- Opioid-free anesthesia reduced PONV incidence (18.2% vs. 36.4%, RR 0.50, 95% CI 0.26-0.97, p=0.032) and severity (OR 0.39, 95% CI 0.16-0.94, p=0.035).
- No serious adverse events were reported in either group.
- The study concluded that opioid-free anesthesia is non-inferior to opioid-based anesthesia for recovery quality and reduces PONV, making it a viable alternative for laparoscopic hysterectomy.