Meta-analysis of opioid-free anesthesia for postoperative analgesia and prognosis in different types of surgery
Lu Hongcheng
Sha Kaiyuan
Yang Bin
Zhang Yue
Ou Cehua
Abstract：Objective To evaluate the efficacy and feasibility of opioid free anesthesia(OFA)for postoperative anal-gesia and prognosis in different types of surgeries.Methods Search Cochrane Library PubMed,Embase,China National Knowledge Infrastructure,Wanfang Database,and VIP Database.Include randomized controlled trials(RCTs)published be-tween the period of self-establishment and March 2023,where at least one study group did not use opioid drugs before surger-y,during anesthesia induction,and before anesthesia recovery.The main outcome measures were postoperative pain scores at 2 and 24 hours,and the secondary outcome measures were extubation time,PACU exit time after anesthesia,incidence of post-operative nausea and vomiting(PONV),opioid dosage,postoperative OFA,and opioid based recovery quality score.Conduct a meta-analysis of the included studies using Revman5.3 software on the Cochrane Collaboration Network.Perform heterogeneity tests on the included literature using Q-value statistical tests and I2 tests.Calculate statistics using fixed effects or random effects models based on inter study heterogeneity,and perform qualitative analysis on data that cannot be subjected to meta-analysis.Results Thirty-seven RCTs were ultimately included,with a total of 2695 patients.Compared with opioid an-esthesia,postoperative 24-hour pain score(MD=-0.73,95％CI-0.92--0.54,I2=61.5％,P=0.0097),PACU extubation time(MD=0.40,95％CI-0.58-1.37,I2=92.6％,P＜0.0001),the postoperative opioid dosage(MD=-2.51,95％CI-3.26--1.77,I2=79.3％,P＜0.001)decreased.OFA has no clinically significant effect on postoperative extubation time,the incidence of PONV,2-hour postoperative pain score,and postoperative recovery quality score.Conclusion OFA can improve the prognosis of weight loss surgery,gynecological and breast surgery,and has no adverse effects on patient safety and pain man-agement.
Keywords：Opioid-free anesthesiaPostoperative recoveryPostoperative nausea and vomitingPostoperative opioid consumptionMeta-analysis
Publication Date：2025-10-18
Online Publishing Date：2025-11-10(First online date of this platform, not the publication date of the document)
Pages：11( 1248-1258 )