Background: Opioid-sparing strategies are recommended, and Opioid-Free Anaesthesia
(OFA) is proposed in the literature. But few data exist about the feasibility of OFA in the routine
practice. From a larger series of 21,463 patients receiving OFA, this work investigates the postoperative
pain and related outcomes in patients undergoing laparoscopic hysterectomy.
Materials and Methods: This matched retrospective study concerned 521 patients scheduled for a
laparoscopic hysterectomy between 2010 and 2015 (118 receiving OFA and 403 receiving anaesthesia
with opioids, AO). Primary outcome was pain in the Post-Anaesthetic Care Unit (PACU).
Results: Among the 521 included patients, 403 received sufentanil (mean±SD: 0.1±0.05 mcg/kg),
the only synthetic opioid used to balance anaesthesia. Concerning the 118 patients receiving OFA,
most of them received an association of clonidine (97%) and ketamine (95%). Most of the patients
in both groups received non-steroidal anti-inflammatory drugs. No difference in pain scores was
observed between AO and OFA (median [IQR], respectively: 4 [0-5] vs. 4.5 [0-6], P=0.74). A difference
in the perioperative morphine equivalent use was observed (mean±SD: 0.18±0.06 mg/kg vs.
0.09±0.06 mg/kg, P<0.001). No difference was observed regarding the nausea/vomiting incidences,
use of anti-emetics, sedation scores, or time spent at the PACU.
Conclusion: Coming from an extensive daily practice, these data show that OFA is feasible and not
associated with higher pain scores or longer PACU stay, suggesting the absence of specific immediate