{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:22:49Z","timestamp":1787840569379,"version":"build-2784847793"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"\n Background and Aims:<\/jats:title>\n To investigate whether opioid-free anaesthesia (OFA) or opioid-based anaesthesia (OBA) technique with ultrasound (US)-guided rectus sheath block (RSB) provides early recovery and less opioid-related side effects in patients undergoing laparotomy for gynaecological malignancy.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This was a double-blind randomised controlled trial. Fifty female patients of the American Society of Anesthesiologists (ASA) physical status I\u2013II, aged 18\u201365 years, and scheduled to undergo elective gynaecological laparotomy under general anaesthesia were included. The patients were randomised into two groups. Both received US-guided RSB with 10 mL of local anaesthetic on each side. Group OBA (\n n<\/jats:italic>\n = 25) received intravenous (IV) fentanyl 2 \u03bcg\/kg at induction and 0.5 \u03bcg\/kg as rescue analgesic. Group OFA (\n n<\/jats:italic>\n = 25) received IV dexmedetomidine (0.5 \u03bcg\/kg bolus over 10 min at induction, followed by 0.3 \u03bcg\/kg\/h infusion) and ketamine (0.25 mg\/kg before incision, 0.15 mg\/kg as rescue analgesic). The primary outcome was the time to attain post-anaesthesia care unit (PACU) discharge criteria. Time to eye-opening, time to extubation, time to shift to PACU, postoperative pain as visual analogue score (VAS), time to first rescue, total 24-h morphine consumption, and any postoperative nausea and vomiting till 24 h were also noted as secondary outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The time to attain PACU discharge criteria was comparable between the groups; however, the time to extubation and time to shift to the PACU was higher in Group OFA (\n P<\/jats:italic>\n = 0.043 and\n P<\/jats:italic>\n = 0.046, respectively). Other secondary outcomes were comparable (\n P<\/jats:italic>\n > 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n OFA provides comparable postoperative analgesia and time to attain PACU discharge in adult patients undergoing open gynaecological oncological surgery under general anaesthesia.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_151_24","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T08:00:15Z","timestamp":1739779215000},"page":"261-267","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Comparison between opioid-based anaesthesia technique and opioid-free anaesthesia technique in patients undergoing laparotomy for gynaecological malignancy: A randomised controlled trial"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3525-7207","authenticated-orcid":false,"given":"Reshma","family":"Kalagara","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, AIIMS, Mangalagiri, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2047-3115","authenticated-orcid":false,"given":"Debesh","family":"Bhoi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3830-5278","authenticated-orcid":false,"given":"Rajeshwari","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7811-7039","authenticated-orcid":false,"given":"Dalim Kumar","family":"Baidya","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Critical Care and Pain Medicine, AIIMS, Guwahati, Assam, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2328-9201","authenticated-orcid":false,"given":"Souvik","family":"Maitra","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9931-2316","authenticated-orcid":false,"given":"Praveen","family":"Talawar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"R1-20250217","first-page":"152","article-title":"The benefits of opioid free anesthesia and the precautions necessary when employing it","volume":"7","author":"Bohringer","year":"2020","journal-title":"Transl Perioper Pain Med"},{"issue":"Suppl 2","key":"R2-20250217","doi-asserted-by":"crossref","first-page":"S91","DOI":"10.4103\/ija.ija_256_22","article-title":"Opioid-free anaesthesia: The conundrum and the solutions","volume":"66","author":"Gupta","year":"2022","journal-title":"Indian J Anaesth"},{"key":"R3-20250217","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.ygyno.2009.03.014","article-title":"A prospective randomized trial comparing patient-controlled epidural analgesia to patient-controlled intravenous analgesia on postoperative pain control and recovery after major open gynecologic cancer surgery","volume":"114","author":"Ferguson","year":"2009","journal-title":"Gynecol Oncol"},{"key":"R4-20250217","doi-asserted-by":"crossref","first-page":"142","DOI":"10.4103\/ija.ija_1099_23","article-title":"Investigation into the clinical performance of rectus sheath block in reducing postoperative pain following surgical intervention: A systematic review and meta-analysis of randomised controlled trials","volume":"68","author":"Jeffries","year":"2024","journal-title":"Indian J Anaesth"},{"key":"R5-20250217","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1007\/s12630-016-0732-9","article-title":"REctus Sheath block for postoperative analgesia in gynecological ONcology Surgery (RESONS): A randomized-controlled trial","volume":"63","author":"Bakshi","year":"2016","journal-title":"Can J Anaesth"},{"key":"R6-20250217","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1007\/s11695-023-06584-5","article-title":"The performance of opioid-free anesthesia for bariatric surgery in clinical practice","volume":"33","author":"Ulbing","year":"2023","journal-title":"Obes Surg"},{"key":"R7-20250217","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1093\/bja\/aet551","article-title":"Opioid-free total intravenous anaesthesia reduces postoperative nausea and vomiting in bariatric surgery beyond triple prophylaxis","volume":"112","author":"Ziemann-Gimmel","year":"2014","journal-title":"Br J Anaesth"},{"key":"R8-20250217","first-page":"183","article-title":"Opioid-free anesthesia: What about patient comfort? A prospective, randomized, controlled trial","volume":"67","author":"Hontoir","year":"2016","journal-title":"Acta Anaesthesiol Belg"},{"key":"R9-20250217","doi-asserted-by":"crossref","first-page":"199","DOI":"10.4103\/aer.AER_74_19","article-title":"Opioid-free total intravenous anesthesia improves postoperative quality of recovery after ambulatory gynecologic laparoscopy","volume":"13","author":"Hakim","year":"2019","journal-title":"Anesth Essays Res."},{"key":"R10-20250217","doi-asserted-by":"crossref","first-page":"E635","DOI":"10.36076\/ppj.2023.26.E635","article-title":"Application of dexmedetomidine as an opioid substitute in opioid-free anesthesia: A systematic review and meta-analysis","volume":"26","author":"Yu","year":"2023","journal-title":"Pain Physician"},{"key":"R11-20250217","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1111\/anae.14582","article-title":"Analgesic impact of intra-operative opioids vs. opioid-free anaesthesia: A systematic review and meta-analysis","volume":"74","author":"Frauenknecht","year":"2019","journal-title":"Anaesthesia"},{"key":"R12-20250217","doi-asserted-by":"crossref","first-page":"1330250","DOI":"10.3389\/fphar.2023.1330250","article-title":"Effect of opioid-free anesthesia on postoperative nausea and vomiting after gynecological surgery: A systematic review and meta-analysis","volume":"14","author":"Zhang","year":"2024","journal-title":"Front Pharmacol"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_151_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:25:11Z","timestamp":1787837111000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_151_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,17]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_151_24","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,17]]},"assertion":[{"value":"2024-02-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}