Comparative Study of Efficacy of Preemptive Use of Opioid-free Anesthesia Using Paracetamol, Magnesium Sulfate, Lignocaine, Dexamethasone versus Intravenous Fentanyl for Attenuating Hemodynamic Response, Perioperative Analgesia, and Postoperative Recovery Profile during Laparoscopic Cholecystectomy: A Randomized Parallel Group Trial
Abstract
Background: Opioids such as fentanyl are widely used in general anesthesia for intraoperative analgesia; however, their use is associated with adverse effects, including respiratory depression, postoperative nausea and vomiting (PONV), ileus, and risk of opioid-related hyperalgesia. Opioid-free anesthesia (OFA) has emerged as an alternative approach utilizing nonopioid agents to provide adequate analgesia while minimizing opioid-related complications. This study aimed to compare the efficacy and safety of OFA with fentanyl-based anesthesia in patients undergoing laparoscopic cholecystectomy.
Materials and methods: This prospective, randomized study included 60 American Society of Anesthesiologists I-II patients undergoing elective laparoscopic cholecystectomy, allocated into two groups ( n = 30 each). Group P received OFA with intravenous paracetamol, magnesium sulfate, lignocaine, and dexamethasone while Group F received fentanyl-based anesthesia. Hemodynamic parameters were recorded intraoperatively. Postoperative pain (Numerical Rating Scale), time to first analgesic request, total analgesic consumption, and incidence of PONV were assessed. Data were analyzed using Student's t -test and Chi-square test, with P < 0.05 considered statistically significant.
Results: The study included 60 patients (30 per group) and demonstrated comparable outcomes between groups. Transient intraoperative differences were noted in heart rate, systolic blood pressure, diastolic blood pressure,…
How strong is the evidence?
Evidence Hub reads this as a randomized trial. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 60 participants or records.
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