Evidence map›Paper›PMID 40269121›Full record

Trial reportScientific reports2025

A blended opioid-free anesthesia protocol and regional parietal blocks in laparoscopic abdominal surgery- a randomized controlled trial.

Giuseppe Accurso, Dario Rampulla, Mariaconcetta Cusenza, Giovanni Candela, Paolino Savatteri, Luigi Vetrugno, Antonino Giarratano, Santi Maurizio Raineri

Erratum issuedAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Giuseppe AccursoDepartment of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy. giuseppe.accurso@policlinico.pa.it.
Dario RampullaDepartment of Neuroscience and Emergency with Trauma Center, A.O.O.R. Villa Sofia Cervello, Palermo, Italy.
Mariaconcetta CusenzaDepartment of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy.
Giovanni CandelaDepartment of Neuroscience and Emergency with Trauma Center, A.O.O.R. Villa Sofia Cervello, Palermo, Italy.
Paolino SavatteriDepartment of Neuroscience and Emergency with Trauma Center, A.O.O.R. Villa Sofia Cervello, Palermo, Italy.
Luigi VetrugnoDepartment of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.
Antonino GiarratanoDepartment of Precision Medicine Disciplines in the Medical Area Surgical and Critical Care, University of Palermo, Palermo, Italy.
Santi Maurizio RaineriDepartment of Precision Medicine Disciplines in the Medical Area Surgical and Critical Care, University of Palermo, Palermo, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In the past 10 years, anesthesiologists have been concentrating on opioid-free anesthesia (OFA) and utilizing locoregional anesthesia/analgesia to manage pain during open and laparoscopic surgeries. The goal is to reduce the negative effects of using opioids during and after surgery. This study aims to evaluate the efficacy and safety of OFA protocol with low doses of magnesium sulfate, Clonidine, and nonsteroidal anti-inflammatory drugs (NSAIDs) employing transversus abdominis plane (TAP) block and rectus sheath block (RSB) for intraoperative and postoperative pain control in laparoscopic abdominal surgery. We conducted a single-center unblinded randomized controlled trial (RCT) to compare the OFA protocol with bilateral TAP and RS block versus the conventional analgesic plan with opioids. We included all consecutive patients older than 18 who planned for laparoscopic scheduled abdominal surgery and underwent general anesthesia. We found a statistically significant lower numeric rating scale (NRS)score at each time point in the OFA group (p < 0.001). A significant statistical difference was also found in the mobilization recovery time, which occurred at 36.00 [18.00, 48.00] hours in the OFA group versus 48.00 [24.00, 72.00] hours in the control one (p < 0.001). The length of stay (LOS) was also in favor of the OFA group 4.00 [2.00, 6.00] days versus 6.00 [4.00, 9.00] days in the control one (p < 0.001). Concerning side effects, there was a reduced/null onset in the OFA group compared with the control. No ICU admissions were recorded in the first 24 h after the end of surgery. This study showed that the preoperative implementation of locoregional anesthesia techniques with our OFA protocols guarantees the adequacy of intraoperative antinociception, while low dose magnesium sulfate and clonidine ensure hemodynamic stability comparable to opioids during surgery. OFA eliminates the side effects of opioids and decreases patients' length of stay and early mobilization without requiring additional drugs.Trial registration ISRCTN15228105. Retrospectively registered 02/12/2023.

Indexed as

AbdomenLaparoscopyNerve BlockPostoperative PainAbdominal MusclesAdultAgedAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalClonidineFemaleHumansMagnesium SulfateMaleMiddle AgedAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalClonidineMagnesium SulfateClonidineLaparoscopic abdominal surgeryMagnesium sulfateOpioid-free anesthesiaRectus sheath blockTransversus abdominis plane block

Identifiers

PMID40269121
PMCPMC12019185

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.