{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:19:49Z","timestamp":1785406789034,"version":"3.56.0"},"reference-count":24,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Settlement Fund for the New Faculty of Konyang University Hospital"},{"id":[{"id":"https:\/\/ror.org\/01eksj726","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Postoperative nausea and vomiting (PONV) remain frequent after breast surgery despite prophylaxis. This single-center, parallel-group randomized controlled trial evaluated whether intraoperative opioid-sparing anesthesia using dexmedetomidine and lidocaine reduced 48 h PONV compared with opioid-based anesthesia. Methods: Adult women undergoing elective breast surgery were randomized 1:1 to opioid-sparing anesthesia with dexmedetomidine and lidocaine or conventional opioid-based anesthesia with remifentanil. Participants and postoperative outcome assessors were blinded to group allocation; attending anesthesiologists were not blinded. All patients received standardized sevoflurane anesthesia, dexamethasone, ramosetron, quantitative neuromuscular monitoring, and postoperative fentanyl patient-controlled analgesia. The primary outcome was PONV within 48 h after surgery. Results: Among 68 randomized patients, 67 were analyzed (opioid-sparing group, n = 33; control group, n = 34). PONV within 48 h occurred in 8 patients (24.2%) in the opioid-sparing group and 28 patients (82.4%) in the control group (risk ratio, 0.29; 95% confidence interval, 0.16\u20130.55; p &lt; 0.001; absolute risk reduction, 58.1%; number needed to treat, 1.7). Rescue antiemetic use was lower in the opioid-sparing group in the postanesthesia care unit and at 1 h postoperatively. Pain scores and cumulative opioid consumption were comparable. No Clavien\u2013Dindo grade III or higher complications occurred. Conclusions: Intraoperative opioid-sparing anesthesia was associated with lower 48 h PONV after breast surgery without apparent compromise in analgesia. These single-center findings, from a trial registered after enrollment of one participant, require confirmation in larger prospectively registered multicenter trials. Trial Registration: Clinical Research Information Service (CRIS), KCT0009829. Registered on 10 October 2024.<\/jats:p>","DOI":"10.3390\/jcm15124459","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T09:46:54Z","timestamp":1780998414000},"page":"4459","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Opioid-Sparing Anesthesia on Postoperative Nausea and Vomiting After Breast Surgery: A Single-Center Randomized Controlled Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0714-1477","authenticated-orcid":false,"given":"Tae-Yun","family":"Sung","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon 35365, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5740-8144","authenticated-orcid":false,"given":"Youngjin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Konyang University Hospital, Daejeon 35365, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8075-845X","authenticated-orcid":false,"given":"Ji-Yoon","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon 35365, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e12430","DOI":"10.1016\/j.heliyon.2022.e12430","article-title":"Risk factors of postoperative nausea and vomiting following ambulatory surgery: A retrospective case-control study","volume":"8","author":"Qian","year":"2022","journal-title":"Heliyon"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1097\/00000542-199909000-00022","article-title":"A simplified risk score for predicting postoperative nausea and vomiting: Conclusions from cross-validations between two centers","volume":"91","author":"Apfel","year":"1999","journal-title":"Anesthesiology"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Echeverria-Villalobos, M., Fiorda-Diaz, J., Uribe, A., and Bergese, S.D. 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