Perioperative medicine & outcomes
Opioid-free anesthesia for minimally invasive abdominal surgery: a systematic review, meta-analysis, and trial sequential analysis
Pooled result · PONV and bradycardiaResult — go to the resultRelative risk 0.55 95% CI 0.40–0.74Authors' conclusion
Opioid-free anesthesia showed a significant reduction in PONV and a decrease in opioid consumption during the first 2 hr postoperatively
Study context
- Population
- Patients undergoing minimally invasive abdominal surgery
- Participants
- 2,025 patients · 26 randomized controlled trials (RCTs)
- Comparison
- Opioid-free vs opioid anesthesia
- Opioid-free anesthesian = 1,009
- Outcome
- Adverse effects (PONV, bradycardia)
Methodological detailstrial sequential analysis
- Trial sequential analysis
Pooled result
PONV and bradycardia
Relative risk
0.55
95% CI 0.40–0.74
P < 0.001
Opioid-free anesthesia vs Opioid anesthesia
RR 0.55 (95% CI 0.40–0.74); P < 0.001
As reported in the abstract
Further pooled results
| Outcome | MD (95% CI) | P value | |
|---|---|---|---|
| Pain scores | −0.9 (−1.7 to −0.2) | P = 0.01 | |
| −2−101Difference (linear scale) |
| Outcome | MD (mg oral morphine equivalents) (95% CI) | P value | |
|---|---|---|---|
| Opioid consumption · 2 hr post surgeryNonclinically relevant | −5.4 (−9.1 to −1.8) | P = 0.004 | |
| −10−505Difference, mg oral morphine equivalents (linear scale) |
- Pain scores: nonclinically relevant higher pain scores for opioid anesthesia
Time to first analgesia
- Reduced time to first analgesia
- 88 min (MD, 88 min; 95% CI, 18 to 159; P = 0.01)
Postanesthesia care unit (PACU) length of stay (LOS)
- No differences in PACU LOS
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| PONV | 0.55 (0.40–0.74) | P < 0.001 | |
| 0.512Relative risk (log scale) |
Bradycardia
- No significant differences in bradycardia rates
Original publication
Opioid-free anesthesia for minimally invasive abdominal surgery: a systematic review, meta-analysis, and trial sequential analysis. Can J Anaesth. Published 5 November 2024. doi:10.
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