ArticleJournal of anesthesia, analgesia and critical care2025
Effectiveness and safety of opioid-free anesthesia compared to opioid-based anesthesia: a systematic review and network meta-analysis.
Article in Journal of anesthesia, analgesia and critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed.
- Comparison of opioid-free versus opioid-based total intravenous anaesthesia in elderly patients undergoing short-duration surgery: a randomized controlled trial.Annals of medicine · 2026Trial
- From index to insight: clinical perspectives on electroencephalographic spectrogram-guided anesthesia-a narrative review.Korean journal of anesthesiology · 2026Review
- Efficacy and safety of Oliceridine versus Sufentanil in postoperative analgesia for burn skin grafting: a machine learning and SHAP-based cohort study.Frontiers in medicine · 2026Article
- Do nonsteroidal anti-inflammatory drugs increase the risk of atrial fibrillation after non-cardiac surgery? Insights from translational and clinical research.Journal of anesthesia, analgesia and critical care · 2025Review
- Opiod-free anesthesia: the importance of evidence synthesis despite heterogeneity.Journal of anesthesia, analgesia and critical care · 2025Article
- Opioid-free anesthesia: comparable analgesia with potential superiority in safety and quality of recovery.Journal of anesthesia, analgesia and critical care · 2025Article
- Postoperative multimodal pain management: a narrative review of current practices, clinical and educational gaps, and future directions.Frontiers in anesthesiology · 2025Article
- Opioid-free anesthesia with esketamine combined with interpectoral plane block and pectoralis-serratus plane blocks in radical mastectomy: a randomized controlled trial.Frontiers in pharmacology · 2025Article
- Effect of opioid-free versus opioid-based anaesthesia among surgical patients in public health care centers: A community medicine perspective.Bioinformation · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOpioid-free anesthesia (OFA) is an innovative approach to anesthesia management aimed at enhancing both the safety and the quality of perioperative outcomes. The efficacy and safety of these approaches are uncertain. The aim of our work was to compare the effectiveness and safety of different OFA regimens to opioid-based anesthesia (OBA). STUDY DESIGN AND
methodsWe conducted a systematic review and frequentist random-effects network meta-analysis of randomized controlled trials (RCTs). The primary outcome measure was the intensity of postoperative pain at 24 h, expressed in terms of numerical rating scale (NRS), visual analogue scale (VAS), or verbal rating scale (VRS) scores. The SUCRA was used to determine the likelihood that an intervention was ranked as the best. The certainty of the evidence was assessed according to the GRADE methodology for Network Meta-analysis (NMA).
resultsA total of 42 RCTs were included, for a total of 4666 patients. We have addressed the variety of available interventions. The random-effects network meta-analysis comparing OBA and different OFA regimens showed no difference in the pain intensity at 24 h. We performed the GRADE assessment for each comparison between each OFA regimen and OBA as a comparator. The certainty of evidence for the primary outcome ranges from moderate to very low among the different comparisons.
conclusionsWe have identified a significant heterogeneity in OFA regimens evaluated and a moderate to high risk of bias in over 70% of studies reporting the primary outcome. No OFA regimens showed a statistically significant effect over OBA in reducing postoperative pain within the first 24 h following surgery. Current evidence does not support the superiority of the analgesic efficacy of OFA in the immediate postoperative period compared to the use of opioids.
trial registrationThis study is registered in PROSPERO with the registration number CRD42024529236 (May 3, 2024).
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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.