A Randomized Controlled Trial Comparing Opioid Free Protocol Using Combination of intravenous Ketamine Dexamethasone and Conventional opioid-based Regime for Laproscopic Tubal Ligation

Laparoscopic tubal ligation is commonly performed under procedural sedation and analgesia using opioid-based regimens. Opioids, although effective, are associated with adverse effects such as respiratory depression, postoperative nausea and vomiting, delayed recovery, and risk of persistent opioid use. Opioid-free anaesthesia (OFA) has emerged as an alternative strategy to reduce opioid-related complications.

This randomized, double-blind controlled trial aims to compare the efficacy and safety of an opioid-free protocol using intravenous ketamine and dexamethasone in combination with propofol versus a conventional opioid-based regimen using fentanyl and propofol in women undergoing laparoscopic tubal ligation.

A total of 100 ASA I–II female patients aged 18–45 years will be randomized into two equal groups. The primary outcomes include postoperative analgesic requirement, intraoperative haemodynamic stability, and additional propofol requirement. Secondary outcomes include postoperative pain scores, postoperative nausea and vomiting, duration of PACU stay, patient satisfaction, failure of opioid-free anaesthesia, and adverse events.

The study aims to evaluate whether the ketamine–dexamethasone combination provides effective analgesia with fewer opioid-related side effects and improved recovery characteristics.