# Patient preference for intraoperative opioid use and early recovery after noncardiac surgery: protocol for a randomised factorial design trial of opioid-free versus opioid-based anaesthesia (the PERFECT trial)

## TL;DR

This study explores whether letting patients choose between opioid-free or opioid-based anesthesia improves recovery after abdominal surgery.

## Contribution

The PERFECT trial is the first to investigate patient preference for opioid use during surgery and its impact on recovery outcomes.

## Key findings

- The trial will assess the effect of patient preference on postoperative recovery quality.
- It will compare opioid-free and opioid-based anesthesia in moderate-risk abdominal surgeries.
- Outcomes include recovery scores, patient satisfaction, and opioid consumption.

## Abstract

Although opioids are commonly used to relieve pain associated with surgery, they are not consequence free. Moreover, the USA and many western countries are currently experiencing a significant health crisis because of opioid addiction and its related overdose potential. There have been no studies that have evaluated patient preference regarding opioid use and its potential impact on the quality of recovery. The aim of this study is to compare the effect of patient preference on intraoperative opioid use on early postoperative quality of recovery after moderate risk laparoscopic/robotic abdominal surgery.

This trial is an interventional, pragmatic, partially randomised factorial trial. Adults (N=240) scheduled for moderate-risk abdominal surgery under laparoscopic/robotic assistance (colorectal, urologic, and gynaecologic) will be allocated into four groups, according to their preference (choice of opioid-free vs opioid-based anaesthesia vs no choice and, if no choice, then the patient is randomised to opioid-based vs opioid-free anaesthesia). Anaesthesia providers and patients who choose their anaesthesia type will be unblinded of the allocation group. The primary endpoint will be the Quality of Recovery-15 score at postoperative day 1. Secondary endpoints will include patient satisfaction, postoperative nausea and vomiting, intraoperative bradycardia, postoperative opioid consumption, postoperative hypoxemia, and health-related quality of life using the EuroQoL 5-Dimension 5-Level (EQ-5D-5L).

This trial will provide evidence on whether patient preference on intraoperative opioid use can improve patient quality of recovery after moderate-risk abdominal surgery.

NCT06855641.

2.0, 24 February 2025.