Opioid-free anaesthesia to reduce postoperative nausea and vomiting after lower extremity wound surgery: a randomised double-blind crossover trial.
Annals of medicine December 1, 2025 Ya-Juan Zhu, Yao-Yu Ying, Hua-Yue Liu et al. 7 citations
Opioid-free anaesthesia (OFA) reduces postoperative nausea and vomiting (PONV) compared with opioid-inclusive anaesthesia in adults undergoing lower extremity wound surgery. In a randomized double-blind crossover trial, 66 patients each received both OFA (lidocaine, esketamine, dexmedetomidine, propofol) and opioid-inclusive anaesthesia (sufentanil, propofol) for two separate surgeries. OFA lowered the incidence of PONV during the first 48 hours after surgery (5% vs. 23%), and also reduced the severity of PONV and rate of hypotension, though time to extubation was longer. Postoperative pain and need for rescue analgesia did not differ between the two techniques.