Opioid-Free versus Opioid-Based Anesthesia for Quality of Recovery After Knee Arthroscopy: A Randomized Non-Inferiority Trial.
Lvdan Huang, Yu Lan, Wangao Li et al.
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From the abstract
We determined whether dexmedetomidine- and esketamine-based opioid-free anesthesia (OFA) was non-inferior to opioid-based anesthesia (OA) for 24-hour Quality of Recovery-15 (QoR-15) after elective knee arthroscopy with femoral nerve block.
Reported results
Mean 24-hour QoR-15 scores were 126.7 ± 6.4 with OFA and 125.3 ± 6.1 with OA (mean difference 1.45, 95% confidence interval [CI] -1.60 to 4.51), establishing non-inferiority but not superiority. OFA increased rescue opioid requirements (Hodges-Lehmann estimate 10 mg oral morphine equivalents, 95% CI 0 to 10; p =0.037), shortened time to rescue analgesia (hazard ratio 2.11, 95% CI 1.14 to 3.92; p =0.018), and…
Authors' conclusions
In adults undergoing elective knee arthroscopy with femoral nerve block, dexmedetomidine- and esketamine-based OFA was non-inferior to OA for 24-hour QoR-15. OFA was associated with lower postoperative nausea and vomiting, but higher early pain and an earlier need for rescue analgesia.