Prevention of Acute Postoperative Pain in Laparoscopic Colorectal Surgery: A Comparison Between Opioid-Free Anesthesia and Conventional Strategy as a Method of Intraoperative Analgesia
Prevention of Acute Postoperative Pain in Laparoscopic Colorectal Surgery: A Comparison Between Opioid-Free Anesthesia and Conventional Strategy as a Method of Intraoperative Analgesia
This study wants to find out if using a pain control method without opioids (Opioid-Free Anesthesia or OFA) works as well as or better than standard anesthesia (which uses opioids) for adults having minimally invasive (laparoscopic) colorectal surgery. Opioids are strong pain medicines often used during surgery, but they can cause side effects like nausea, vomiting, slower digestion, and breathing problems.
Researchers will divide participants into two groups by chance (like flipping a coin). One group will receive the opioid-free anesthesia, which uses a combination of other types of pain medicines. The other group will receive standard anesthesia with opioids. The main goal is to see if the opioid-free method reduces pain and the need for extra pain medicine in the first 24 hours after surgery. The study will also look at whether patients have fewer side effects, wake up more comfortably, and can leave the hospital sooner.
Inclusion Criteria:
Exclusion Criteria:
Postoperative pain management is a critical component of Enhanced Recovery After Surgery (ERAS) pathways, particularly in major abdominal procedures such as laparoscopic colorectal surgery. Traditionally, intraoperative and postoperative analgesia relies heavily on opioid administration. However, opioid use is frequently associated with adverse events-including postoperative nausea and vomiting (PONV), paralytic ileus, respiratory depression, and hyperalgesia-which can delay functional recovery and prolong hospital stays.
Opioid-Free Anesthesia (OFA) is a multimodal analgesic strategy that utilizes non-opioid pharmacological agents to block sympathetic nervous system responses and prevent central sensitization. This study is a prospective, single-blind, randomized controlled trial designed to evaluate the efficacy and safety of an OFA protocol compared to standard Opioid-Based Anesthesia (OBA). The OFA protocol utilizes a customized combination of agents, including Dexmedetomidine, Ketamine, Lidocaine, Magnesium Sulfate, and Dexamethasone.
Eligible adult patients (ASA I-III) scheduled for elective laparoscopic colorectal surgery will be randomized in a 1:1 ratio to either the OFA or OBA group. Standardized clinical pathways will be followed for all patients outside of the specific anesthetic interventions. Data collection will occur from the intraoperative period through 24 hours post-surgery, with continuous follow-up extending until hospital discharge.
By comparing these two approaches, this trial aims to provide robust clinical evidence on whether completely eliminating intraoperative opioids can optimize postoperative pain control, reduce the incidence of classic opioid-related adverse effects, enhance overall patient satisfaction, and accelerate surgical recovery in colorectal patients.