{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:57:19Z","timestamp":1793321839652,"version":"4.5.0"},"reference-count":60,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:00:00Z","timestamp":1636588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Opioid\u2010based treatment is used to manage stress responses during surgery and postoperative pain. However, opioids have both acute and long\u2010term side effects, calling for opioid\u2010free anaesthetic strategies. This meta\u2010analysis compares adverse events, postoperative recovery, discharge time from post\u2010anaesthesia care unit, and postoperative pain, nausea, vomiting, and opioid consumption between strict opioid\u2010free and opioid\u2010based general anaesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta\u2010analysis. We searched PubMed, Embase, Cinahl, Cochrane Library, selected reference lists, and Google Scholar. We included randomised controlled trials (RCTs) published between January 2000 and February 2021 with at least one opioid\u2010free study arm, i.e. no opioids administered preoperatively, during anaesthesia induction, before skin closure, or before emergence from anaesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study comprised 1934 patients from 26 RCTs. Common interventions included laparoscopic gynaecological surgery, upper gastrointestinal surgery, and breast surgery. There is firm evidence that opioid\u2010free anaesthesia significantly reduced adverse postoperative events (OR 0.32, 95% CI 0.22 to 0.46, I\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a056%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001), mainly driven by decreased nausea (OR 0.27, (0.17 to 0.42),\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001) and vomiting (OR 0.22 (0.11 to 0.41),\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001). Postoperative opioid consumption was significantly lower in the opioid\u2010free group (\u22126.00\u00a0mg (\u22128.52 to \u22123.48),\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001). There was no significant difference in length of post\u2010anaesthesia care unit stay and overall postoperative pain between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Opioid\u2010free anaesthesia can improve postoperative outcomes in several surgical settings without evidence of adverse effects on patient safety and pain management. There is a need for more evidence\u2010based non\u2010opioid anaesthetic protocols for different types of surgery as well as postoperative phases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.13994","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T13:46:34Z","timestamp":1635774394000},"page":"170-185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":126,"title":["Total opioid\u2010free general anaesthesia can improve postoperative outcomes after surgery, without evidence of adverse effects on patient safety and pain management: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6488-8406","authenticated-orcid":false,"given":"Alexander","family":"Olausson","sequence":"first","affiliation":[{"name":"Institute for Health and Care Sciences at Sahlgrenska Academy University of Gothenburg  Gothenburg 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Medicine\/Pain Centre Sahlgrenska University Hospital Region V\u00e4stra G\u00f6taland  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7518-8915","authenticated-orcid":false,"given":"Pether","family":"Jildenst\u00e5l","sequence":"additional","affiliation":[{"name":"Institute for Health and Care Sciences at Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Anaesthesiology and Intensive Care \u00d6rebro University Hospital and School of Medical Sciences \u00d6rebro University  \u00d6rebro Sweden"},{"name":"Department of Anaesthesia, Operation and Intensive Care Sahlgrenska University Hospital Region V\u00e4stra G\u00f6taland  Gothenburg Sweden"},{"name":"Department of Health Sciences Lund University  Lund 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