Anesthetics as an Alternative to Opioids in Laparoscopic Surgeries: An Observational Study
Bibliographic record
Abstract
BACKGROUND: Laparoscopic surgery, though minimally invasive, often results in significant postoperative pain, particularly in the initial hours. While opioids remain a conventional analgesic choice, their use is associated with adverse effects, including respiratory depression, sedation, nausea, and dependency. This study aimed to evaluate the efficacy of opioid-free multimodal analgesia using epidural with general anesthesia to minimize opioid requirements and related complications. METHODS: This observational study was conducted on 50 patients aged >20 years, with American Society of Anesthesiologists (ASA) grade I, II, and III, posted for surgeries under general anesthesia at C.U. Shah Medical College and Hospital, Surendranagar from January 2021 to June 2022 to evaluate opioid free anesthesia in major laparoscopic surgeries on perioperative hemodynamics and postoperative analgesia. The patients were given general anesthesia with epidural anesthesia. RESULTS: The study population comprised 42 (84%) female and eight (16%) male patients. Hemodynamic monitoring showed stable parameters with no significant variations in heart rate after non-depolarizing muscle relaxant administration, at one hour, two hours, and four hours postoperatively. Similarly, systolic blood pressure, diastolic blood pressure, and mean arterial pressure remained stable at all measured time points. Pain assessment using the visual analog scale revealed mild discomfort at extubation (mean score: 2.76 ± 0.64), which progressively decreased over the subsequent 24 hours. Sedation level, measured by the Ramsay Sedation Scale, was at its peak at extubation (3.72 ± 0.48) and gradually declined to near-baseline levels by four hours post extubation (1.96 ± 1.13). Cognitive function evaluation using the Montreal Cognitive Assessment showed no significant difference between preoperative (27.9 ± 1.37) and 24-hour postoperative (26.72 ± 1.37) scores. The incidence of postoperative nausea and vomiting was 18%, successfully managed with 0.15 mg/kg ondansetron, with no other complications reported. CONCLUSION: Opioid-free anesthesia combining epidural ropivacaine with general anesthesia provides effective analgesia in laparoscopic surgeries, as evidenced by stable hemodynamics, acceptable pain scores, minimal sedation, high patient satisfaction, and no significant cognitive impairment. This approach may serve as a viable alternative to opioid-based analgesia, reducing associated side effects.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".