Karatay

Postoperative ileus (POI) is a frequent complication after abdominal surgery that delays bowel movement recovery, lengthens hospital stays, and raises healthcare costs. This trial evaluates the effects of two opioids, fentanyl and remifentanil, which are commonly used during surgery but have different impacts on bowel function and pain. The study aims to compare these drugs' influence on gastrointestinal recovery and pain after elective laparoscopic gallbladder removal in patients aged 18 to 65 years with good physical health (ASA I-II). Participants will be randomly assigned to receive either fentanyl or remifentanil during surgery. Those in the fentanyl group will get a 2 micrograms per kilogram intravenous bolus at anesthesia induction, followed by an infusion of 1 to 2 micrograms per kilogram per hour. The remifentanil group will receive a 1 microgram per kilogram bolus and an infusion of 0.1 to 1 microgram per kilogram per minute. Both groups will also receive standard anesthesia with propofol, rocuronium, and sevoflurane. The study will monitor recovery during and after surgery, focusing on bowel function and pain. Participants will be observed for time until first bowel movement (flatus) up to 72 hours after surgery. Other measures include time to first bowel movement, ability to tolerate oral food, occurrence of prolonged POI, pain levels, pain medication use, nausea and vomiting, recovery room and hospital stay lengths, and patient satisfaction. The trial seeks to identify which opioid offers better postoperative bowel recovery and pain control after laparoscopic cholecystectomy.