Table 3.
Short-term postoperative outcomes indices in OFA and OA groups.
| Outcome | OFA (n = 98) | OA (n = 97) | Effect estimate (95% CI) | P value |
|---|---|---|---|---|
| Analgesia (μg) | ||||
| Sufentanil consumption, 24 h | 72 ± 31.0 | 74.9 ± 32.4 | −2.9 (−11.5 to 5.7) | 0.032* |
| Sufentanil consumption, 48 h | 144 ± 35.9 | 162 ± 30.7 | −18.0 (−27.4 to −8.6) | 0.010* |
| Pain (VAS) (median [IQR]) | ||||
| PACU, rest | 0 [2] | 2 [1] | – | <0.001* |
| PACU, cough | 1 [2] | 2 [1] | – | <0.001* |
| POD1–3 (rest/cough)# | Similar | Similar | – | NS |
| PONV incidence (n, %) | RR (95% CI) | |||
| PACU | 0 (0%) | 1 (1.0%) | – | 0.497 |
| 24 h | 23 (23.5%) | 53 (54.6%) | 0.43 (0.29–0.64) | <0.001* |
| 48 h | 14 (14.3%) | 34 (35.1%) | 0.41 (0.23–0.71) | 0.001* |
| 72 h | 6 (6.1%) | 19 (19.6%) | 0.31 (0.13–0.75) | 0.005* |
| Recovery times (median [IQR]) | ||||
| Extubation (min) | 26 [20] | 10 [10] | +16 min | <0.001* |
| PACU stay (min) | 60 [30] | 40 [18] | +20 min | <0.001* |
| Time to flatus (h) | 47 [34] | 56 [31] | –9 h | 0.045* |
| Hospital stay (days) | 8 [2] | 8 [2] | 0 | 0.400 |
| Postoperative delirium (n, %) | 1 (1.0%) | 1 (1.0%) | RR 1.00 | 1.000 |
| Sleep quality (RCSQ) (mean ± SD) | ||||
| RCSQ 24 h | 51.8 ± 36.8 | 33.9 ± 36.1 | +17.9 (7.60 to 28.20) | 0.012* |
| RCSQ 48 h | 61.3 ± 22.9 | 58.2 ± 26.8 | +3.1 (−3.95 to 10.15) | 0.112 |
| RCSQ 72 h | 63 ± 21.7 | 57.7 ± 16.6 | +5.3 (−0.16 to 10.76) | 0.062 |
| Intraoperative hypertension (n, %) | 21 (21.6%) | 7 (7.2%) | 3.00 (1.13–6.75) | 0.004 |
| Perioperative characteristics (median [IQR]) | ||||
| Surgery duration (min) | 170 [71] | 185 [60] | −15 min | 0.319 |
| Anesthesia duration (min) | 206 [117] | 205 [65] | +1 min | 0.989 |
| Fluid infused (mL) | 1800 [800] | 1700 [600] | +100 mL | 0.934 |
| Urine output (mL) | 370 [258] | 450 [440] | −80 mL | 0.070 |
| Intraoperative adverse events (n, %)## | RR (95% CI) | |||
| Hypertension | 21 (21.6%) | 7 (7.2%) | 2.97 (1.32–6.66) | 0.004* |
| Hypotension | 37 (37.8%) | 34 (35.1%) | 1.08 (0.75–1.55) | 0.695 |
| Bradycardia | 9 (9.2%) | 4 (4.1%) | 2.23 (0.71–6.99) | 0.157 |
| Tachycardia | 4 (4.1%) | 4 (4.1%) | 0.99 (0.25–3.85) | 1.000 |
Values are expressed as mean ± standard deviation (SD), median [interquartile range, IQR], or number (percentage). OFA, opioid-free anesthesia; OA, opioid-based anesthesia; VAS, visual analogue scale; PACU, post-anesthesia care unit; PONV, postoperative nausea and vomiting; POD, postoperative day; RCSQ, Richards–Campbell Sleep Questionnaire; NS, not significant; RR, relative risk; CI, confidence interval; RR, relative risk; CI, confidence interval. No adjustment for multiplicity was performed for secondary outcomes. * P < 0.05 indicates statistical significance. # POD1–3 (rest/cough) indicates VAS pain scores assessed at rest and during coughing on postoperative days 1–3. ## Intraoperative hemodynamics were guided by heart rate, mean arterial pressure, and bispectral index according to institutional protocol.