Intraoperative haemodynamic responses to opioid-free anaesthesia versus anaesthesia with fentanyl for laparoscopic cholecystectomy—a prospective observational pilot study

Opioid-free anaesthesia (OFA) avoids the use of perioperative opioids and can achieve the goals of hypnosis, amnesia, and haemodynamic stability. This single-centre observational study of sixty-four adult patients undergoing laparoscopic cholecystectomy aimed to compare the haemodynamic profiles of an OFA protocol and opioid-based anaesthesia (OBA) in laparoscopic cholecystectomy. The OFA group received dexmedetomidine, lidocaine, ketamine, and magnesium sulphate, while the OBA group received fentanyl. Propofol, rocuronium, and sevoflurane were also administered to all patients. The patients’ systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate were recorded. Two temporal courses were created, i.e., one for 15 min post-induction (PI) and another for the entire surgery (PI and at baseline (T1), at the time of skin incision (T2), after 30 min (T3) and 60 min (T4), and at the end of surgery (T5)). Instances of hypotension were also noted. The groups had similar demographic characteristics. There were no statistically significant differences in intraoperative haemodynamic variables between the two groups, except that at 3 and 5 min after PI, SBP, DBP, and MAP values were significantly lower in the OBA group. Intraoperative haemodynamic changes with OFA were comparable to those observed with OBA, indicating that OFA may be a suitable alternative for patients undergoing laparoscopic cholecystectomy.