Opioid-free anaesthesia improves outcomes in gynaecological laparoscopic surgery

A new study published in BMC Anesthesiology suggests that The opioid-free anesthesia (OFA) approach is comparable to the opioid-based anaesthesia (OA) technique in terms of analgesic impact and intraoperative anaesthetic stability in gynaecological laparoscopic surgery under the enhanced recovery after surgery (ERAS) protocol. 

The benefits of opioid-free anaesthesia in gynaecological laparoscopic surgery under the ERAS protocol are not entirely clear, but they are now often utilised in a variety of surgical specialties, including gynaecological surgery. In order to compare the efficacy and viability of the OFA approach with the conventional OA technique in gynaecological laparoscopic surgery under ERAS, Liang Chen and colleagues carried out this study.

During gynaecological laparoscopic surgery, adult female patients aged 18 to 65 were randomly assigned to either the OFA group (Group OFA, n = 39) with esketamine and dexmedetomidine or the OA group (Group OA, n = 38) with sufentanil and remifentanil. Every patient followed the ERAS protocol. Area under the curve (AUC) of Visual Analogue Scale (VAS) scores (AUCVAS) postoperatively was the main result. The Pittsburgh Sleep Quality Index (PSQI) perioperatively, intraoperative hemodynamic variables, awakening and orientation recovery times, number of postoperative rescue analgesia needed, incidence of postoperative nausea and vomiting (PONV), and awakening and orientation recovery times were all considered secondary outcomes.