2025, Vol. 8, Issue 4, Part A
Opioid free anesthesia using a combination of lignocaine and ketamine in patients undergoing laparoscopic cholecystectomy: A double blinded randomized control trial
Author(s): Senapati Krishan Kumar, Banerjee Avijit, Mandal Sibnath and Dutta Akash
Abstract: Background: Opioids have been used since inception by the anesthesiologists in almost all the major surgeries but it comes with its own set of side effects. Opioid free anesthesia has been the center of attraction from the past few years as it saves the patients from common side effects. Non opioid anesthesia provides a safer alternative to selected patients and also helps in enhanced recovery after surgery. We analyzed post-operative analgesic requirement of patients scheduled for elective laparoscopic cholecystectomy. Methodology: This study has included 80 patients within the age group of 20-60 years with American society of anesthesiologist’s physical status I and II who underwent laparoscopic cholecystectomy. Patients who had given consent for study, were randomly divided into 2 groups of 40 people each. The opioid free group which was the study group was administered an intravenous bolus and infusion of lignocaine and intravenous bolus of ketamine, whereas the control group received intravenous bolus of fentanyl. The primary objective was to analyze post operative pain via numeric rating scale (NRS) score during 24hrs post operative period between both the groups. The secondary objective was to analyze vital signs, post operative nausea and vomiting, mean arterial pressure (MAP), heart rate (HR), itching and also the total amount of pethidine consumed during 24hrs post-operative period. Results: The study revealed several important findings regarding the efficacy and safety of opioid-free anesthesia (OFA) using lignocaine and ketamine in laparoscopic cholecystectomy. The OFA group had significantly mean lower postoperative fentanyl consumption at 2 hours (35.3 mcg vs. 70.1 mcg, p<0.001) and 6 hours (19.9 mcg vs. 38.4 mcg, p = 0.023), indicating better early postoperative pain control. Pain scores measured using the Numerical Rating Scale (NRS) were consistently lower in the OFA group at all time points, with significant differences at 2 hours (3.7±0.89 vs 5.6±0.49, p<0.001) and 6 hours (2.55±0.93 vs. 3.65±0.58, p<0.001). The incidence of postoperative nausea and vomiting (PONV) was significantly lower in the OFA group, with mild PONV observed in 87.5% compared to 65% in the OBA group (p = 0.017). Pruritus was entirely absent in the OFA group, whereas 20% of patients in the OBA group experienced itching (p = 0.003). Conclusion: Opioid-free anaesthesia with lignocaine and ketamine in laparoscopic cholecystectomy provides effective pain relief while reducing opioid-related adverse effects, enhancing postoperative recovery.
DOI: 10.33545/26643766.2025.v8.i4a.598
Pages: 18-24 | Views: 119 | Downloads: 74
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How to cite this article:
Senapati Krishan Kumar, Banerjee Avijit, Mandal Sibnath, Dutta Akash. Opioid free anesthesia using a combination of lignocaine and ketamine in patients undergoing laparoscopic cholecystectomy: A double blinded randomized control trial. Int J Med Anesthesiology 2025;8(4):18-24. DOI: 10.33545/26643766.2025.v8.i4a.598
