Efficacy of nonopioid analgesics and adjuvants in multimodal analgesia for reducing postoperative opioid consumption and complications in obesity: a systematic review and network meta-analysis
Authors' conclusion
Intravenous nonopioid analgesics and adjuvants are crucial in multimodal anaesthesia, reducing opioid consumption and enhancing postoperative care in adult surgical patients with obesity.
Study context
- Population
- Adult surgical patients with obesity
- Participants
- 3,602 patients · 37 RCTs
- Comparison
- Nonopioid i.v. analgesics and adjuvants vs placebo/no intervention or a comparator
- Outcome
- Perioperative opioid consumption
Methodological detailsRoB 2, GRADE, Searched PubMed, Scopus, Web of Science, CINAHL, EMBASE; English-language RCTs only
- RoB 2
- GRADE
- Searched PubMed, Scopus, Web of Science, CINAHL, EMBASE; English-language RCTs only
Pooled result
As reported in the abstract
Postoperative opioid consumption
- Dexmedetomidine, ketamine, lidocaine, magnesium and gabapentin significantly reduced postoperative opioid consumption vs placebo/no intervention or a comparator
Further pooled results
Postoperative pulmonary complications (POPCs)
- Ketamine/esketamine significantly reduced POPCs
Postoperative nausea
- Ibuprofen, dexmedetomidine and lidocaine significantly reduced postoperative nausea
Postoperative vomiting
- Dexmedetomidine, alone or combined with pregabalin, and lidocaine reduced postoperative vomiting
PACU length of stay (LOS)
- Dexmedetomidine significantly reduced PACU LOS
Hospital LOS
- Paracetamol and lidocaine reduced hospital LOS
Original publication
Efficacy of nonopioid analgesics and adjuvants in multimodal analgesia for reducing postoperative opioid consumption and complications in obesity: a systematic review and network meta-analysis. Br J Anaesth. Published 3 October 2024. doi:10.
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