CLINICAL TRIAL article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1665123
Comparison of opioid-free versus weak-opioid general anesthesia on quality of postoperative recovery in soldiers undergoing arthroscopic meniscal surgery
Provisionally accepted- The General Hospital of Northern Command, Shenyang, China
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Objective To determine whether opioid-free anesthesia improves early postoperative recovery compared with weak-opioid anesthesia in soldiers undergoing meniscal surgery for training-related injuries. Method A total of 100 patients scheduled for elective meniscal surgery were randomized into two groups (n = 50 each): weak-opioid anesthesia group (WOA) and opioid-free anesthesia (OFA) group. Anesthesia induction consisted of alfentanil 0.2 μg/kg in the WOA group and esketamine 0.2 mg/kg in the OFA group. Intraoperatively, the OFA group received esketamine 0.2 mg/kg/h, lidocaine 1 mg/kg/h, and sevoflurane (MAC 1.0–1.4). The WOA group received remifentanil 0.1 μg/kg/h and sevoflurane (MAC 0.8–1.0). The primary endpoint was the QoR15 score at 24 h postoperatively. Results The OFA group achieved significantly higher QoR15 scores at 24, 48, and 72 h, with the 24-h difference exceeding the threshold for clinical significance. The OFA group was associated with longer awakening times but earlier return of gastrointestinal function (shorter time of flatus). Intraoperatively, the WOA group experienced greater reductions in heart rate and mean arterial pressure, with a higher incidence of remarkable bradycardia. Postoperatively, the OFA group reported lower NPRS scores across the first three days, required less rescue analgesia, and had a lower incidence of rebound pain. Conclusion Compared with weak-opioid anesthesia, opioid-free anesthesia significantly improves early postoperative recovery quality, as measured by the QoR15, in soldiers undergoing arthroscopic meniscal surgery.
Keywords: Opioid-free anesthesia, Weak opioid anesthesia, QoR15 scores, soldier, Meniscus surgery
Received: 13 Jul 2025; Accepted: 01 Oct 2025.
Copyright: © 2025 Sun, Ding, Han, Wang, Sun and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lin Li, lilinslashofmine@qq.com
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