{
  "abstract": "We determined whether dexmedetomidine- and esketamine-based opioid-free anesthesia (OFA) was non-inferior to opioid-based anesthesia (OA) for 24-hour Quality of Recovery-15 (QoR-15) after elective knee arthroscopy with femoral nerve block. In this patient- and assessor-blinded randomized trial, 70 adults undergoing knee arthroscopy with femoral nerve block were allocated to OFA or OA. The primary outcome was 24-hour QoR-15 (non-inferiority margin, -6 points). Secondary outcomes included pain, rescue analgesia, and adverse events. The primary modified intention-to-treat (mITT) analysis included 66 randomized participants with an assessable 24-hour QoR-15 score (33 per group). Mean 24-hour QoR-15 scores were 126.7 ± 6.4 with OFA and 125.3 ± 6.1 with OA (mean difference 1.45, 95% confidence interval [CI] -1.60 to 4.51), establishing non-inferiority but not superiority. OFA increased rescue opioid requirements (Hodges-Lehmann estimate 10 mg oral morphine equivalents, 95% CI 0 to 10; p=0.037), shortened time to rescue analgesia (hazard ratio 2.11, 95% CI 1.14 to 3.92; p=0.018), and increased early pain. OFA reduced postoperative nausea and vomiting (21.2% vs 48.5%; relative risk 0.44, 95% CI 0.21 to 0.92; p=0.038). Two postoperative bradycardia events occurred with OFA. In adults undergoing elective knee arthroscopy with femoral nerve block, dexmedetomidine- and esketamine-based OFA was non-inferior to OA for 24-hour QoR-15. OFA was associated with lower postoperative nausea and vomiting, but higher early pain and an earlier need for rescue analgesia. Chinese Clinical Trial Registry, ChiCTR2400084207; registered 13 May 2024, before enrollment. URL: https://www.chictr.org.cn/showproj.html?proj=230255.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.",
    "Graduate School, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.",
    "Department of Anesthesiology, Wenzhou Central Hospital Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.",
    "Department of Pain, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.",
    "Oujiang Laboratory, Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China."
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lvdan Huang",
      "orcid": "0000-0002-1211-9733"
    },
    {
      "affs": [
        1
      ],
      "name": "Yu Lan"
    },
    {
      "affs": [
        1
      ],
      "name": "Wangao Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaona Zhu"
    },
    {
      "affs": [
        2,
        3,
        4
      ],
      "name": "Wujun Geng",
      "orcid": "0000-0001-5599-3036"
    },
    {
      "affs": [
        0
      ],
      "name": "Kejian Shi",
      "orcid": "0000-0003-1396-7424"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/abc3c44y9qgha.bib",
  "cited_by": 0,
  "doi": "10.2147/dddt.s644051",
  "fulltext_url": "https://europepmc.org/articles/PMC13714700",
  "id": "abc3c44y9qgha",
  "issns": [
    "1177-8881"
  ],
  "landing_url": "https://europepmc.org/article/MED/42953556",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Trial Report"
    ],
    [
      "openalex",
      "2746|Anesthesia and Pain Management"
    ]
  ],
  "openalex": "W7223285740",
  "pdf_url": "https://europepmc.org/articles/PMC13714700?pdf=render",
  "pmcid": "PMC13714700",
  "pmid": "42953556",
  "published": "2026-10-23",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/abc3c44y9qgha.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:40Z",
      "native_id": "MED:42953556",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42953556"
    },
    {
      "first_seen": "2026-11-01T12:22:08Z",
      "native_id": "PMC13714700",
      "source": "pmc",
      "url": "https://doi.org/10.2147/dddt.s644051"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Anesthesia and Pain Management",
      "subfield": "surgery"
    }
  ],
  "title": "Opioid-Free versus Opioid-Based Anesthesia for Quality of Recovery After Knee Arthroscopy: A Randomized Non-Inferiority Trial.",
  "title_text": "Opioid-Free versus Opioid-Based Anesthesia for Quality of Recovery After Knee Arthroscopy: A Randomized Non-Inferiority Trial.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:22:08Z",
  "url": "https://research.draconitic.com/paper/abc3c44y9qgha",
  "venue": "Drug design, development and therapy",
  "versions": []
}