Quality of Recovery After Laparoscopic Ovarian Cystectomy: A Randomized Controlled Trial Comparing Opioid-Free Multimodal Analgesia Versus Opioid-Based Anesthesia
Abstract
Background: Opioid-based anesthesia, though effective for pain control, is often associated with side effects such as nausea, vomiting, and delayed recovery. In the context of minimally invasive procedures like laparoscopic ovarian cystectomy, there is increasing interest in opioid-free anesthesia (OFA) to enhance postoperative outcomes.
Objective: To compare the quality of recovery between opioid-free and opioid-based anesthesia using the QoR-15 score in patients undergoing laparoscopic ovarian cystectomy.
Methods: This double-blind, randomized controlled trial included 80 ASA I-II female patients aged 18-65 undergoing elective laparoscopic ovarian cystectomy. Participants were randomized equally to receive either opioid-free multimodal anesthesia (dexmedetomidine, lidocaine, ketamine, paracetamol) or conventional opioid-based anesthesia. The primary outcome was QoR-15 score at 24 hours. Secondary outcomes included intraoperative anesthetic requirements, hemodynamic stability, postoperative pain, and adverse events.
Results: Patients in the OFA group had significantly higher QoR-15 total scores (192 vs. 173; p = 0.029), especially in physical comfort (p = 0.014), independence (p = 0.035), and pain domains (p = 0.021). The OFA group also required a lower propofol maintenance dose (5.64 ± 1.21 vs. 6.32 ± 1.81 mg/kg/h; p = 0.012), had a longer time to first analgesic request (42.6 ± 7.52 vs. 33.6 ± 7.17 min; p = 0.003), and experienced fewer adverse effects such as nausea (15%…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 15 participants or records.
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.