Objective To evaluate the effect of opioid-free anesthesia (OFA) regimen combined with ultrasound-guided transversus abdominis plane block (TAPB) on the postoperative recovery quality of patients undergoing laparoscopic cholecystectomy.

Methods A total of 92 patients scheduled by LC were selected, and randomly divided into the observation group and control group at a ratio of 1∶1, with 46 cases in each group. In the observation group, the bilateral TAPB was performed before anesthesia induction, with 20 mL of 0.25% ropivacaine injected on each side, and the Dexmedetomidine, propofol, esketamine, lidocaine, sevoflurane, and rocuronium were used for anesthesia induction and maintenance. The control group was treated with propofol, sufentanil, remifentanil, sevoflurane and rocuronium for anesthesia induction and maintenance. The QoR-15 score before operation, after 24 hours and 48 hours of operation, hemodynamics, postoperative recovery, postoperative pain and complications were evaluated.

Results The QoR-15 scores of the observation group were higher than those of the control group after 24 hours and 48 hours of operation (P ＜ 0.05). The heart rate and mean arterial pressure of the observation group after 1 minute of intubation, after 5 minutes of pneumoperitoneum establishment and at the end of operation were all lower than those of the control group (P ＜ 0.01). The time of first getting out of bed, time of first anal exhaust and time of first intake of liquid food in the observation group after surgery were all shorter than those in the control group (P ＜ 0.05). The NRS scores of the observation group after12 hours and 24 hours of operation were both lower than those of the control group (P ＜ 0.05). The incidences of hypotension and postoperative nausea and vomiting in the observation group were both lower than those in the control group (P ＜ 0.05).

Conclusions The OFA strategy combined with TAPB can effectively relieve postoperative pain in LC patients, maintain intraoperative circulatory stability, significantly reduce the incidence of nausea and vomiting, accelerate the recovery of gastrointestinal function, and improve the quality of postoperative recovery.