Quality of recovery (QoR-15) following opioid-free versus opioid anaesthesia for elective endoscopic nasal surgeries: A randomised, open-label comparative trial.

Abstract

Background and aims: Newer modalities like opioid-free analgesia overcome the opioid-related side effect profile and are equally efficacious. This study aims to compare the clinical outcomes between opioid-free anaesthesia (OFA) and opioid-based anaesthesia (OA) in elective nasal endoscopic surgeries.

Methods: A randomised, open-label trial was conducted to evaluate the quality of recovery (QoR). The study included 64 patients with American Society of Anesthesiologists physical status I and II, of either gender, aged between 18 and 60 years, scheduled for elective endoscopic nasal surgery at a tertiary care centre. The patients were randomised into two groups: Group OA (patients receiving opioid anaesthesia) and Group OFA (patients receiving opioid-free anaesthesia). The primary outcome was the effects of OFA versus OA on the QoR-15 in patients undergoing endoscopic nasal surgeries under general anaesthesia. Secondary outcomes included intraoperative haemodynamics, respiratory depression, nausea/vomiting, pruritus, postoperative analgesia, and length of stay in the post-anaesthesia care unit. An independent sample t-test and Chi-squared test were employed for between-group comparisons.

Results: Patients undergoing OFA showed higher postoperative QoR-15 scores compared to the opioid group. Intraoperatively, the OFA group demonstrated a better haemodynamic profile at 15, 30, 60, 90, and 120 min, with lower mean arterial pressure values compared to the opioid group. Notably, the OFA group experienced reduced nausea/vomiting and pruritus. Postoperative analgesia requirements and length of stay in recovery were also lower in the OFA group.

Conclusion: OFA in elective nasal endoscopic surgeries results in higher QoR-15 scores, better postoperative analgesia and fewer adverse effects associated with opioids.