ArticleFrontiers in medicine2025
Efficacy of opioid-free anesthesia in reducing postoperative nausea and vomiting following gynecological laparoscopic surgery: a randomized controlled trial.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Increasing dose of esketamine for supplemental analgesia after complex spinal fusion surgery: a randomized and double-blind trial.BMC anesthesiology · 2026Trial
- Oliceridine versus Sufentanil on Postoperative Nausea and Vomiting in Women Undergoing Gynecological Laparoscopic Surgery: A Randomized Double‑Blind Controlled Trial.Drug design, development and therapy · 2026Trial
- Combined epidural-general anesthesia reduces opioid use and improves recovery after laparoscopic hysterectomy: a retrospective cohort study.Perioperative medicine (London, England) · 2026Article
- Effect of total intravenous opioid-free anesthesia on quality of recovery following gynecological laparoscopy: protocol for a multicenter, randomized, double-blind, controlled trial.Frontiers in medicine · 2026Article
- Esketamine for Postoperative Multimodal Analgesia in Laparoscopic Surgery: A Systematic Review and Meta-Analysis.Journal of pain research · 2026Review
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Authors and funding
6 authors.
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Abstract
Background: Postoperative nausea and vomiting (PONV) are a common complication following gynecological laparoscopic surgery, with opioid use being a significant contributing risk factor. Opioid-free anesthesia (OFA) has emerged as an alternative approach to mitigate opioid-related adverse effects. This study aimed to evaluate the efficacy of OFA in reducing PONV and its impact on postoperative recovery. Methods: This randomized, double-blind, controlled trial enrolled 92 female patients undergoing elective gynecological laparoscopic surgery. The patients were randomized 1:1 into two groups, whereby the OFA group received anesthesia with esketamine (0.3 mg/kg) and dexmedetomidine (0.6 μg/kg), while the control group received conventional opioid-based anesthesia with sufentanil (0.3 μg/kg). Both groups underwent preoperative transversus abdominis plane (TAP) block with ropivacaine (20 mL per side). Standardized perioperative monitoring and analgesic protocols were maintained. The primary outcome was the incidence of PONV within 48 h postoperatively. Secondary outcomes included the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score recovery time, postoperative pain scores, antiemetic and analgesic use, and quality of recovery (QoR-15 scores). Results: On postoperative day 1, PONV incidence was significantly lower in the OFA group (15.2%) compared to the control group (34.8%) ( Conclusion: Opioid-free anesthesia incorporating TAP block may reduce early PONV following gynecological laparoscopic surgery while maintaining adequate pain control and overall recovery quality.
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