Perioperative medicine & outcomes
Opioid-free versus opioid-based anesthesia for postoperative nausea and vomiting in laparoscopic cholecystectomy: A Systematic Review with Meta-Analysis, Meta-Regression and Trial Sequential Analysis
Pooled result · PONVResult — go to the resultRelative risk 0.30 95% CI 0.18–0.48Authors' conclusion
The available pooled evidence in the literature indicates, with moderate certainty, that opioid-free anesthesia reduces PONV without compromising postoperative analgesia or intraoperative hemodynamic stability in patients undergoing laparoscopic cholecystectomy.
Study context
- Population
- Patients undergoing laparoscopic cholecystectomy
- Participants
- 1,065 patients · 10 RCTs
- Comparison
- Opioid-free vs opioid-based anesthesia
- Outcome
- Incidence of postoperative nausea and vomiting (PONV)
Methodological detailsmeta-regression, trial sequential analysis, GRADE
- Meta-regression
- Trial sequential analysis
- GRADE
Pooled result
PONV
Relative risk
0.30
95% CI 0.18–0.48
P < 0.001
Opioid-free vs Opioid-based
RR 0.30 (95% CI 0.18–0.48); P < 0.001
As reported in the abstract
Further pooled results
| Outcome | MD (95% CI) | P value | |
|---|---|---|---|
| Postoperative pain (NRS) · 2 h | −0.72 (−1.05 to −0.39) | P < 0.001 | |
| Postoperative pain (NRS) · 8 h | −0.83 (−1.20 to −0.46) | P < 0.001 | |
| Postoperative pain (NRS) · 24 h | −0.16 (−0.40 to 0.07) | P = 0.177 | |
| −1.5−1−0.500.5Difference (linear scale) |
Need for rescue analgesia, opioid consumption within 24 h
- No differences observed
Safety
Intraoperative hypotension
- Significantly reduced in the opioid-free group
Bradycardia
- No differences observed
Original publication
Opioid-free versus opioid-based anesthesia for postoperative nausea and vomiting in laparoscopic cholecystectomy: A Systematic Review with Meta-Analysis, Meta-Regression and Trial Sequential Analysis. Anaesth Crit Care Pain Med. Published 27 May 2026. doi:10.
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