{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T10:39:08Z","timestamp":1794307148314,"version":"4.9.0"},"reference-count":20,"publisher":"The Korean Society of Anesthesiologists","issue":"2","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["anesth-pain-med.org"],"crossmark-restriction":true},"short-container-title":["Anesth Pain Med"],"published-print":{"date-parts":[[2024,4,30]]},"abstract":"<jats:p>Background: Opioids administered as bolus doses or continuous infusions are widely used by anesthesiologists worldwide for major and day care surgeries. Opioid-free anesthesia is a multimodal anesthesia and analgesia technique that does not use opioid drugs, thereby benefitting patients from opioid-related adverse effects. In this study, we compared the postoperative analgesic requirements of patients scheduled for elective laparoscopic cholecystectomy under opioid-free and opioid-based anesthesia.Methods: This study included 88 patients aged 18\u201360 years with American Society of Anesthesiologists physical status 1 and 2 who underwent elective laparoscopic cholecystectomy. Participants were randomly divided into two groups with forty-four participants in each group. The opioid-free anesthesia group was administered an intravenous bolus of ketamine and dexmedetomidine, whereas the opioid-based group was administered fentanyl with conventional general anesthesia. The primary outcome was to compare the total amount of fentanyl consumed by both groups during the 6 h postoperative period following extubation. Episodes of postoperative nausea and vomiting (PONV) and vital signs were noted throughout the postoperative period to analyze the secondary outcomes.Results: Both the groups had similar demographic characteristics. The opioid-free group required less postoperative analgesia within the first 2 h (61.4 \u00b1 17.4 vs. 79.0 \u00b1 19.4 of fentanyl, P &lt; 0.001), which was statistically significant. However, fentanyl consumption was comparable between the groups at the sixth postoperative hour (opioid-free group 152 \u00b1 28.2 vs. opioid group 164 \u00b1 33.4, P = 0.061). Compared with 4.5% of the participants in the opioid-free group, 34% of those in the opioid-based group developed moderate PONV.Conclusions: The opioid-free anesthesia technique in patients undergoing laparoscopic cholecystectomy reduced the requirement of analgesia in the first two hours of the postoperative period and was associated with decreased PONV.<\/jats:p>","DOI":"10.17085\/apm.23097","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T04:50:02Z","timestamp":1713502202000},"page":"109-116","update-policy":"https:\/\/doi.org\/10.17085\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Opioid-free anesthesia using a combination of ketamine and dexmedetomidine in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial"],"prefix":"10.17085","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7317-6345","authenticated-orcid":true,"given":"Vishnuraj","family":"K R","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4485-8757","authenticated-orcid":true,"given":"Kunal","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8297-5538","authenticated-orcid":true,"given":"Nishant","family":"Sahay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4107-2671","authenticated-orcid":true,"given":"Chandni","family":"Sinha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4272-5750","authenticated-orcid":true,"given":"Amarjeet","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9161-7000","authenticated-orcid":true,"given":"Neeraj","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2573","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2017.05.004"},{"key":"ref2","first-page":"991","volume-title":"Opioid-induced hyperalgesia in patients after surgery: a systematic review and meta-analysis","author":"Fletcher","year":"2014"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000180204.64588.ec"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0000000000003887"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1900"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1159\/000337028"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-014-0275-x"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/bf03021622"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097\/aln.0b013e3181e90914"},{"key":"ref10","first-page":"191","volume-title":"Impact of perioperative dexamethasone on postoperative analgesia and side effects: a systematic review and meta-analysis","author":"Waldron","year":"2013"},{"key":"ref11","first-page":"770","volume-title":"Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: Aa systematic review with trial sequential analysis","author":"Weibel","year":"2016"},{"key":"ref12","first-page":"1170","volume-title":"Combining paracetamol (acetaminophen) with nonsteroidal anti-inflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain","author":"Ong","year":"2010"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000282822.07437.02"},{"key":"ref14","first-page":"1312","volume-title":"Effect of perioperative systemic alpha2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials","author":"Blaudszun","year":"2012"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd012033"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000108501.57073.38"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjane.2014.05.001"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.joacp_382_18"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet551"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1097\/aln.0000000000003725"}],"container-title":["Anesthesia and Pain 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