Pain medicine

Opioid-free anesthesia: A systematic review and meta-analysis

J Clin AnesthPublished Systematic review and meta-analysis of randomised trials

Pooled result · Postoperative NRS scoresResult — go to the resultPooled mean difference 0.39 points CI 0.19–0.59

Authors' conclusion

We concluded that we cannot recommend one strategy over the other.

Study context

Population
Patients undergoing GA38 studies
Comparison
Opioid-free anesthesia vs opioid based anesthesia
Outcome
Acute and chronic pain scores (Numeric Rating Scale (NRS) or VAS)
Methodological detailsrandom effects model, RoB2 risk of bias assessment
  • Random effects model
  • RoB2 risk of bias assessment

Pooled result

Postoperative NRS scores · postoperative period

Pooled mean difference

0.39 points

CI 0.19–0.59

OFA vs OBA
pooled mean difference 0.39 points (CI 0.19–0.59)

As reported in the abstract

Further pooled results

OutcomePooled mean difference (MME) (CI)
Postoperative opioid consumption · postoperative periodNo clinically relevant difference; moderate quality evidence4.02 (1.73–6.30)
OutcomeMean difference (points)
Quality of recoverySuperior with OFA · pooled analysis of only two studies8.26

Safety

Postoperative nausea and vomiting (PONV) occurred less with opioid free anesthesia (OFA), but bradycardia was more frequent

Original publication

Opioid-free anesthesia: A systematic review and meta-analysis. J Clin Anesth. Published 27 July 2023. doi:10.1016/j.jclinane.2023.111215

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