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已发表论文
无阿片类药物麻醉对 65 至 80 岁老年患者全髋关节置换术后早期恢复质量的影响（通过 QoR-15 评分评估）：一项随机对照试验
Authors Su Y, Qin Z , Li X , Zhang X, Tong F, Wu L , Kong M
Received 10 June 2025
Accepted for publication 9 September 2025
Published 7 October 2025 Volume 2025:19 Pages 9127—9136
DOI https://doi.org/10.2147/DDDT.S545896
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Yajing Su,* Zhe Qin,* Xiaolong Li, Xinlei Zhang, Fei Tong, Liwei Wu, Mingjian Kong
Department of Anesthesiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Mingjian Kong, Department of Anesthesiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China, Tel +86 17751991669, Email mjkong@126.com
Purpose: Opioid administration in elderly surgical patients is link to multiple adverse effects that may impede postoperative recovery. We aimed to compare the impact of opioid-free anesthesia (OFA) versus conventional opioid-based anesthesia on postoperative recovery quality in elderly patients undergoing total hip arthroplasty (THA).
Methods: We randomized 68 elderly patients undergoing primary total hip arthroplasty under general anesthesia into either an opioid-free anesthesia group (Group OFA) or conventional opioid-based group (Group C). The primary outcome was quality of recovery assessed by the Quality of Recovery-15 (QoR-15) scores at 24h postoperatively. Secondary outcomes included: QoR-15 scores at 72h postoperatively, perioperative hemodynamic parameters, extubation time and PACU duration, NRS pain scores, postoperative sufentanil consumption and adverse event incidence.
Results: The QoR-15 scores statistically significant differed between the two groups at 24h postoperatively (112.2± 5.0 vs 102.6± 4.7, mean difference = 9.6,95% CI: 7.3– 12.0, P< 0.001) and 72h postoperatively (123.5± 3.9 vs 120.4± 3.9, mean difference = 3.1,95% CI: 1.2– 5.0, P= 0.02). However, by 72h, the observed difference did not reach minimum clinical important difference (MCID). Group OFA exhibited shorter extubation times and a reduced duration of stay in the PACU. Mean arterial pressure (MAP) showed statistically significant differences at T1, T2, and T4, as did the heart rates (HR) at T1–T4. NRS scores differed both at rest and during passive hip flexion in the PACU, and at 6 and 24 hours postoperatively. Additionally, Group OFA demonstrated reduced sufentanil consumption within the first 24 and 48 hours after surgery and a lower incidence of nausea and vomiting.
Conclusion: We concluded that OFA provided superior early recovery outcomes compared to conventional opioid-based anesthesia in elderly total hip arthroplasty patients, with improvements in pain, emotional state, and physical comfort domains.
Keywords: opioid-free anesthesia, total hip arthroplasty, elderly, postoperative recovery quality
Department of Anesthesiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Mingjian Kong, Department of Anesthesiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China, Tel +86 17751991669, Email mjkong@126.com
Purpose: Opioid administration in elderly surgical patients is link to multiple adverse effects that may impede postoperative recovery. We aimed to compare the impact of opioid-free anesthesia (OFA) versus conventional opioid-based anesthesia on postoperative recovery quality in elderly patients undergoing total hip arthroplasty (THA).
Methods: We randomized 68 elderly patients undergoing primary total hip arthroplasty under general anesthesia into either an opioid-free anesthesia group (Group OFA) or conventional opioid-based group (Group C). The primary outcome was quality of recovery assessed by the Quality of Recovery-15 (QoR-15) scores at 24h postoperatively. Secondary outcomes included: QoR-15 scores at 72h postoperatively, perioperative hemodynamic parameters, extubation time and PACU duration, NRS pain scores, postoperative sufentanil consumption and adverse event incidence.
Results: The QoR-15 scores statistically significant differed between the two groups at 24h postoperatively (112.2± 5.0 vs 102.6± 4.7, mean difference = 9.6,95% CI: 7.3– 12.0, P< 0.001) and 72h postoperatively (123.5± 3.9 vs 120.4± 3.9, mean difference = 3.1,95% CI: 1.2– 5.0, P= 0.02). However, by 72h, the observed difference did not reach minimum clinical important difference (MCID). Group OFA exhibited shorter extubation times and a reduced duration of stay in the PACU. Mean arterial pressure (MAP) showed statistically significant differences at T1, T2, and T4, as did the heart rates (HR) at T1–T4. NRS scores differed both at rest and during passive hip flexion in the PACU, and at 6 and 24 hours postoperatively. Additionally, Group OFA demonstrated reduced sufentanil consumption within the first 24 and 48 hours after surgery and a lower incidence of nausea and vomiting.
Conclusion: We concluded that OFA provided superior early recovery outcomes compared to conventional opioid-based anesthesia in elderly total hip arthroplasty patients, with improvements in pain, emotional state, and physical comfort domains.
Keywords: opioid-free anesthesia, total hip arthroplasty, elderly, postoperative recovery quality