Comparing Opioid-Free and Opioid-Based Anesthesia for Elective Urological Surgery Including Laparoscopic and Robotic Nephrectomy, Prostatectomy, and Cystectomy

What this Trial Is About

Researchers are evaluating opioid-free anesthesia OFA compared to standard opioid-based anesthesia remifentanil in patients undergoing elective urological surgeries such as laparoscopic or robotic nephrectomy, prostatectomy, and cystectomy. This randomized controlled trial aims to assess whether OFA reduces postoperative opioid use and related side effects, with a focus on total oxycodone consumption in the first 24 hours after surgery. Secondary goals include assessing pain levels, postoperative nausea and vomiting, kidney function, and immune response. Participants will be randomly assigned to receive either opioid-free anesthesia, which includes infusions of ketamine, lidocaine, dexmedetomidine, and sevoflurane inhalation, or opioid-based anesthesia with remifentanil infusion during surgery. Both groups will receive regional analgesia tailored to the surgical procedure and postoperative pain control through oxycodone delivered by a patient-controlled analgesia PCA pump, along with paracetamol and metamizole. The study follows a well-established OFA protocol and compares it to standard care. During the study, participants pain will be regularly assessed up to 24 hours after surgery using a numeric rating scale. Blood tests will monitor kidney function and white blood cell counts before and after surgery. Researchers will also record opioid consumption through PCA and evaluate side effects like nausea. The total participation includes the surgery day and 24 hours of postoperative follow-up.

Opioid-free Anesthesia as an Alternative to General Anesthesia in Abdominal Surgery