{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:12:47Z","timestamp":1788862367204,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100017959","name":"Health Commission of Hebei Province","doi-asserted-by":"publisher","award":["20251414"],"award-info":[{"award-number":["20251414"]}],"id":[{"id":"10.13039\/100017959","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n Opioid\u2010based anesthesia in laparoscopic hysterectomy is associated with adverse effects (e.g., postoperative nausea and vomiting [PONV], ileus, cognitive impairment) that impede recovery. This study evaluates whether opioid\u2010free anesthesia (OFA) combined with an Enhanced Recovery After Surgery (ERAS) protocol improves postoperative recovery quality.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study included 255 patients who underwent laparoscopic total hysterectomy between February 2023 and April 2025. Patients were allocated to TOA (124 patients received traditional opioid\u2010based anesthesia) and OFA\u2009+\u2009ERAS (131 patients received OFA combined with ERAS) groups. Outcomes included recovery times, hemodynamic stability, pain scores (Visual Analog Scale [VAS]), cognitive function (Mini\u2010Mental State Examination [MMSE]), adverse events, sleep quality, and quality of life (QOR\u201015, Activities of Daily Living [ADL]). Multivariate analyses were performed to adjust for potential confounders.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The OFA\u2009+\u2009ERAS group demonstrated significantly shorter time to awakening (\n p<\/jats:italic>\n \u2009<\u20090.001), extubation (\n p<\/jats:italic>\n \u2009<\u20090.001), first flatus (\n p<\/jats:italic>\n \u2009<\u20090.001), and hospital stay (\n p<\/jats:italic>\n \u2009<\u20090.001). Postoperative pain scores were consistently lower in the OFA\u2009+\u2009ERAS group at all time points (all\n p<\/jats:italic>\n \u2009<\u20090.001), with a 72% reduction in the odds of tramadol use (OR\u2009=\u20090.28, 95% CI: 0.14\u20130.56,\n p<\/jats:italic>\n \u2009<\u20090.001). The incidence of PONV (OR\u2009=\u20090.35,\n p<\/jats:italic>\n \u2009=\u20090.002) and postoperative cognitive dysfunction (OR\u2009=\u20090.31,\n p<\/jats:italic>\n \u2009=\u20090.008) was significantly reduced. The OFA\u2009+\u2009ERAS group also showed better hemodynamic stability during surgery and improved MMSE, sleep quality, QOR\u201015, and ADL scores at 48\u2009h postoperatively (all\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n OFA combined with ERAS enhances postoperative recovery in laparoscopic total hysterectomy by reducing pain, opioid\u2010related complications, and hospital stay while improving cognitive and functional outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jog.70323","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:53:51Z","timestamp":1778633631000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Opioid\u2010Free Anesthesia Combined With Enhanced Recovery After Surgery Protocol on Postoperative Recovery Quality in Patients Undergoing Laparoscopic Total Hysterectomy"],"prefix":"10.1111","volume":"52","author":[{"given":"Yingbing","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Xingtai People's Hospital Xingtai Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecology Xingtai People's Hospital Xingtai Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyun","family":"Liu","sequence":"additional","affiliation":[{"name":"Operating Room Xingtai People's Hospital Xingtai Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuxia","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Xingtai People's Hospital Xingtai Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiyuan","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Xingtai People's Hospital Xingtai Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4015-7623","authenticated-orcid":false,"given":"Guohua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Xingtai People's Hospital Xingtai Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06821-9"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-021-03068-2"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000036396"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-023-02236-4"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.2217\/cer-2021-0258"},{"issue":"5","key":"e_1_2_13_7_1","first-page":"952","article-title":"Enhanced Recovery After Surgery (ERAS) in Gynecology Oncology. 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