{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:39:14Z","timestamp":1786653554689,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"ABSTRACT<\/jats:title>\n \n Introduction:<\/jats:title>\n Opioid-free anaesthesia (OFA), when incorporated into enhanced recovery after surgery (ERAS) pathways, may improve peri-operative safety and recovery in patients with obesity. We evaluated the efficacy and safety of a multimodal OFA regimen incorporating loco-regional anaesthesia in this population undergoing general anaesthesia.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n \n In this prospective randomised study with participant and outcome-assessor blinding, 380 adults (body mass index >35 kg\/m\n 2<\/jats:sup>\n ) undergoing elective laparoscopic cholecystectomy were randomised to receive OFA or non-OFA (N-OFA). The OFA group received dexmedetomidine (0.3\u20130.5 \u03bcg\/kg\/h), low-dose ketamine (0.2 mg\/kg) and an ultrasound-guided subcostal transversus abdominis plane block with 30 ml of 0.25% bupivacaine. The N-OFA group received fentanyl (1\u20132 \u03bcg\/kg ideal body weight). All patients received total intravenous anaesthesia. The primary outcome was time to discharge readiness (DR). Secondary outcomes included pain scores, opioid requirement, quality of recovery-40 (QoR-40) and airway-related adverse events (ARAEs).\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Baseline characteristics were comparable, and pain scores were significantly lower in the OFA group at 3 and 24 h (\n P<\/jats:italic>\n < 0.001). At 24 h, 61.1% of patients in the OFA group reported no pain compared with 42.6% in the N-OFA group. Rescue opioid requirement was markedly reduced (2.1% vs. 95.5%,\n P<\/jats:italic>\n < 0.001). Time to DR was shorter (9.7 \u00b1 1.6 h vs. 11.6 \u00b1 2.7 h,\n P<\/jats:italic>\n < 0.001), and QoR-40 scores were higher in the OFA group. ARAEs were not statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n OFA using loco-regional block, dexmedetomidine and ketamine improves recovery, reduces opioid use and accelerates DR in patients with obesity undergoing laparoscopic surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jmas.jmas_35_26","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:00:09Z","timestamp":1777557609000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Opioid-free anaesthesia with loco-regional block enhances safety and recovery in patients with obesity undergoing non-bariatric surgery: A randomised controlled trial"],"prefix":"10.4103","author":[{"given":"Aparna","family":"Sinha","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Max Institute of Laparoscopy, Endoscopy, Robotic and Bariatric Surgery, Max Super Specialty Hospital, New 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