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Background and Aims Opioid-free anesthesia in the perioperative period reduces the risk of opioid-related side effects and enhances recovery by minimizing postoperative nausea, sedation, and respiratory depression. We wanted to assess the effects of OFA on bowel recovery, PONV, pain scores and hospital stay inpatients undergoing Radical Cystectomy with Ileal Conduit (RCIC) and Retroperitoneal Lymph Node Dissection (RPLND).Methods Thirty two patients undergoing RCIC and RPLND were randomised into two groups – OFA study arm (n=16) and with standard opiods arm OA (n=16). Both the groups received propofol and vecuronium for induction of anaesthesia followed by inhalational anaesthetic agents for maintenance of anaesthesia. The OA group received fentanyl at the time of induction while the OFA group received intravenous lignocaine. Epidural catheter was placed for intraoperative and post-operative analgesia through which the OFA group received 0.125% levobupivacaine while the OA group received 0.1 levobupivacaine with 2 mcg/cc Fentanyl. Both groups received Ondansetron as PONV prophylaxis. In addition, paracetamol and diclofenac were also used for post-operative analgesia.Results The study revealed that the time to passage of flatus was lower in the OFA group (51.731 vs 60.731, p=0.366) but not statistically significant. Intra-operative hemodynamic parameters, post-operative pain scores and incidence of PONV were comparable in both group of patients. However, the severity of PONV measured as number of doses of anti-emetics required to control PONV was more in the OA group (1.85 vs 0.54, p=0.099). Length of hospital stay was lower in the OFA group (9.75 vs 13.31 days, p=0.150) but not statistically significant. Remaining parameters were comparable in both the groupsConclusions OFA did not provide any advantage over opioid based anaesthesia. However, it can be used as an alternative in patients who are prone to the side effects of opioids.