Opioid-Free versus Opioid-Sparing Anesthesia

CA-3 · I.A.4.c.1 II.C.1.c.1.a.1 II.D.1.b.1.b

37Sources
6Kept
0Dropped

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37 candidate papers

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6 points

Across 23 trials, pain at two hours was equivalent whether or not intraoperative opioid was given, while postoperative nausea and vomiting was lower without it. PMID 30802933 kept
Expect higher processed EEG indices during opioid-free anaesthesia: patient state index and spectral edge frequency ran higher, and the alpha power typical of opioid-based technique was absent. PMID 39856547 kept
Pooling 38 trials, opioid-free and opioid-based anaesthesia produced no clinically relevant difference in postoperative pain scores or opioid consumption. PMID 37515877 kept
A dexmedetomidine-based opioid-free technique was stopped early after five cases of severe bradycardia, and increased opioid-related adverse events from 67% to 78%, driven by hypoxaemia. PMID 33630043 kept
In laparoscopic bariatric surgery, opioid-free anaesthesia reduced nausea and vomiting more than opioid-sparing anaesthesia, but roughly doubled the risk of bradycardia with no difference in pain or opioid use. PMID 38578868 kept
In day-case hip arthroplasty, opioid-free anaesthesia did not reduce 24-hour opioid consumption compared with opioid-sparing anaesthesia, with similar pain scores and walking recovery. PMID 38044236 kept

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