Evidence map›Paper›PMID 40371564›Full record

Trial reportEuropean journal of anaesthesiology2025

Effects of an opioid-free care pathway vs. opioid-based standard care on postoperative pain and postoperative quality of recovery after laparoscopic bariatric surgery: A multicentre randomised controlled trial.

Alexander Olausson, Pether Jildenstål, Paulin Andréll, Eva Angelini, Erik Stenberg, Ville Wallenius, Henrik Öhrström, Sven-Egron Thörn, Axel Wolf

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter StudyComparative Study
In one paragraph

Trial report in European journal of anaesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03756961 (Effects of an Opioid Sparing Care Pathway for Patients Undergoing Obesity Surgery), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03756961 narecruitingnot on this map

Effects of an Opioid Sparing Care Pathway for Patients Undergoing Obesity Surgery

TypeinterventionalSponsorGöteborg UniversityRan2019 to 2029Enrolled220ConditionsObesity, Pain, PostoperativeArmsDexmedetomidine, Person-centred care (PCC), Esketamine, Lidocaine, Transcutaneous Nerve Stimulation (TENS)
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Alexander OlaussonFrom the Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg (AO, PJ, EA, AW), Department of Health Sciences, Lund University (PJ), Department of Anesthesiology and Intensive Care, Skåne University Hospital, Lund (PJ), Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg (PA, S-ET), Department of Anaesthesiology and Intensive Care Medicine/Pain Centre, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg (PA), Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro (ES), Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg (VW), Department of Surgery, Sahlgrenska University Hospital/Östra, Region Västra Götaland, Gothenburg (VW), Department of Anesthesiology and Intensive Care, Örebro University Hospital, Region Örebro län, Örebro (HÖ), Department of Anesthesiology and Intensive Care, Lindesberg Hospital, Region Örebro län, Lindesberg (HÖ), Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital/Östra, Region Västra Götaland, Gothenburg, Sweden (S-ET, AW), Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway (AW) and Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden (AW).ORCID 0000-0001-6488-8406
Pether Jildenstål
Paulin Andréll
Eva Angelini
Erik Stenberg
Ville Wallenius
Henrik Öhrström
Sven-Egron Thörn
Axel Wolf

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOpioid-free anaesthesia (OFA) may enhance postoperative recovery after bariatric surgery, but its combined effect with opioid-free interventions has not been studied.

objectivesTo compare postoperative pain and recovery after laparoscopic bariatric surgery with a total opioid-free care pathway and conventional opioid-based treatment.

designA multicentre nonblinded controlled trial.

settingTwo university hospitals in Sweden. PATIENTS: Adult patients scheduled for laparoscopic bariatric surgery were enrolled between May 2019 and November 2023. Of 837 patients screened, 112 were randomised, and 110 were included in the analysis: 55 in the intervention and 55 in the control group.

interventionsPatients were randomised to an opioid-based standard care (control group) or to an opioid-free care pathway (intervention group), including intraoperative OFA and postoperative first-line transcutaneous electrical nerve stimulation (TENS) treatment.

main outcome measuresThe primary outcome was the change in patient-reported postoperative pain intensity on a numerical rating scale (NRS) from arrival in the postanaesthesia care unit (PACU) until discharge to the surgical ward. Key secondary outcomes were postoperative pain intensity, in-hospital opioid consumption, and postoperative quality of recovery scale (PQRS) scores.

resultsThere was no difference between the groups regarding the changes in pain intensity from arrival in PACU until discharge to the ward, with mean ± SD changes in NRS of 3.20 ± 3.01 (intervention) vs. 3.15 ± 2.25 (control); mean difference (MD) 0.04 [(95% confidence interval (CI), -1.00 to 1.08); P  = 0.97], and pain intensity at 24 h ( P  = 0.078), 72 h ( P  = 0.060), and 3 months ( P  = 0.30) postoperatively. The intervention group had a significantly lower opioid consumption in the PACU; mean morphine equivalents 6.08 ± 12.31 vs. 51.1 ± 14.9 mg; MD -45.0 (95% CI, -50.1 to -39.8) mg; P  < 0.0001; and during the hospital stay MD -40.3 (95% CI, -54.4 to -25.9) mg; P  < 0.0001. Total PQRS scores did not differ significantly over the 3-month follow-up.

conclusionThe opioid-free care pathway offers patients pain relief and recovery outcomes comparable to conventional opioid-based care and reduces opioid use after laparoscopic bariatric surgery.

trial registrationClinicalTrials.gov NCT03756961.

Indexed as

Analgesics, OpioidBariatric SurgeryLaparoscopyPostoperative PainAdultFemaleHumansMaleMiddle AgedPain MeasurementSwedenTranscutaneous Electric Nerve StimulationAnalgesics, Opioid

Identifiers

PMID40371564
PMCPMC12237137

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.