الفهرس 
INTRODUCTION AND RATIONALOnly 14 pages are availabe for public view
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Abstract
The introduction of opioids in the clinical practice was a revolution and has been considered one of the main pillars of the anesthetic practice for decades. By blocking the sympathetic response to surgical stimuli and obtaining a reduced requirement of hypnotic agents, better perioperative hemodynamic stability and emergence were possible.
However, administration of opioids can be associated with several side effects that can be responsible for delayed patient recovery and hospital discharge, as well as leading to increased health service costs. Furthermore, opioid administration consequences are neither scarce nor benign for the patient. Perioperative opioids are associated with nausea and vomiting, (4) sedation, ileus, confusion/delirium, respiratory depression, increased postoperative pain and morphine consumption, immunodepression and hyperalgesia.
So, this randomized single-blinded clinical trial study was carried out to assess if the opioid free-anesthesia reduce the systemic inflammatory stress responses, reduce postoperative opioid-related adverse effects, possess hemodynamic stability, and enhance functional outcome compared to opioid-balanced anesthesia in the patients undergoing elective oncologic abdominal surgery.
Our study was carried out on patients with ASA physical status III or ІV underwent elective oncologic abdominal surgery under general anesthesia.
The patients were randomly assigned into onegroup (1) (OBA) group included patients who received bilateral erector spinae plane block in addition to TIVA by fentanyl as basic analgesic in addition to continuous IV infusion of propofol and varying its
rate to keep the spectral entropy in the target range intra-operatively. of two equal groups on alternative basis: