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Salomé A, Harkouk H, Fletcher D, et al. Opioid-Free Anesthesia Benefit-Risk Balance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med. 2021;10(10)doi: 10.3390/jcm10102069.
Salomé, A., Harkouk, H., Fletcher, D., & Martinez, V. (2021). Opioid-Free Anesthesia Benefit-Risk Balance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of clinical medicine, 10(10), . https://doi.org/10.3390/jcm10102069
Salomé, Arthur, et al. "Opioid-Free Anesthesia Benefit-Risk Balance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials." Journal of clinical medicine vol. 10,10 (2021). doi: https://doi.org/10.3390/jcm10102069
Salomé A, Harkouk H, Fletcher D, Martinez V. Opioid-Free Anesthesia Benefit-Risk Balance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med. 2021 May 12;10(10). doi: 10.3390/jcm10102069. PMID: 34065937; PMCID: PMC8150912.
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J Clin Med. 2021 May 12;10(10). doi: 10.3390/jcm10102069.

Opioid-Free Anesthesia Benefit-Risk Balance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Journal of clinical medicine

Arthur Salomé, Hakim Harkouk, Dominique Fletcher, Valeria Martinez

Affiliations

  1. Service d'anesthésie, Hôpital Ambroise Paré et Raymond Poincaré, Boulogne Billancourt et Garches, Assistance Publique Hôpitaux de, 92380 Paris, France.
  2. Department of Anesthesia, Université Paris-Saclay, UVSQ, Inserm, LPPD, 92100 Boulogne, France.

PMID: 34065937 PMCID: PMC8150912 DOI: 10.3390/jcm10102069

Abstract

Opioid-free anesthesia (OFA) is used in surgery to avoid opioid-related side effects. However, uncertainty exists in the balance between OFA benefits and risks. We searched for randomized controlled trials (RCTs) comparing OFA to opioid-based anesthesia (OBA) in five international databases. The co-primary outcomes were postoperative acute pain and morphine consumption at 2, 24, and 48 h. The secondary outcomes were the incidence of postoperative chronic pain, hemodynamic tolerance, severe adverse effects, opioid-related adverse effects, and specific adverse effects related to substitution drugs. Overall, 33 RCTs including 2209 participants were assessed. At 2 h, the OFA groups had lower pain scores at rest MD (0.75 (-1.18; -0.32)), which did not definitively reach MCID. Less morphine was required in the OFA groups at 2 and 24 h, but with very small reductions: 1.61 mg (-2.69; -0.53) and -1.73 mg (

Keywords: adverse effect; analgesia; anesthesia; opioid-free anesthesia; systematic review

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