{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:34:27Z","timestamp":1791909267847,"version":"4.3.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Opioid-free anesthesia (OFA) provides adequate analgesia minimizing opioids. OFA has not been evaluated in laparoscopic radical prostatectomy (LRP). Our aim was to evaluate OFA feasibility and its effectiveness in LRP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>A quasi-experimental retrospective study of 55 adult patients undergoing LRP was performed from September 2020 until December 20223. Predefined protocols for either opioid-based anesthesia (OBA; with continuous remifentanil infusion) or OFA (continuous lidocaine, dexmedetomidine, and ketamine infusion) were followed. In both groups, wound infiltration was performed before skin incision. Primary outcome was postoperative pain management (numerical rating scale [NRS]) in the first 24 postoperative hours. Secondary outcomes were opioid consumption, start to sitting and ambulation, postoperative complications, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      OFA protocol patients had better median pain scores during movement at 1, 18 and 24 h, that is, 1 (interquartile range [IQR] 0\u20133) versus 2.5 (IQR 0\u20134),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.047; 0 (IQR 0\u20131) versus 1 (IQR 0\u20132),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.017; and 0 (IQR 0\u20130.25) versus 1 (IQR 0\u20132),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.013, respectively. At 6 and 12 h, there were no statistically significant differences, that is, 0.5 (IQR 0\u20132) versus 1 (IQR 0\u20132),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.908 and 1 (IQR 0\u20132) versus 0.5 (IQR 0\u20132),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.929, respectively. Lower morphine requirements were recorded in the first 18 and 24 postoperative hours, that is, 0 (IQR 0\u20130) versus 1 (IQR 0\u20132.75) mg,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.028 and 0 (IQR 0\u20132) versus 1.5 (IQR 0\u20133) mg,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.012, respectively. Start to sitting and ambulation occurred earlier in the OFA group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.030 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002, respectively). Linear regression showed that ambulation was independently associated with the analgesic technique (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.034). Only one patient had postoperative nausea and vomiting (PONV) and belonged to the OBA group. There was no difference in total complications or the length of stay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this study, OFA strategy was found to be safe, feasible, and provided adequate analgesia, minimizing the use of postoperative opioids, and was independently associated with earlier ambulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joacp.joacp_375_23","type":"journal-article","created":{"date-parts":[[2024,4,7]],"date-time":"2024-04-07T22:01:40Z","timestamp":1712527300000},"page":"523-529","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Feasibility of opioid-free anesthesia in laparoscopic radical prostatectomy: A retrospective, quasi-experimental 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