{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:16:01Z","timestamp":1791468961043,"version":"4.3.4"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"DOI":"10.1186\/s12871-025-03497-x","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:51:49Z","timestamp":1765536709000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of opioid-free anesthesia in reducing postoperative adverse events for thoracoscopic pulmonary surgery: a randomized controlled trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Ran","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weixin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"3497_CR1","doi-asserted-by":"publisher","first-page":"3036","DOI":"10.1053\/j.jvca.2020.05.022","volume":"34","author":"G Devine","year":"2020","unstructured":"Devine G, Cheng M, Martinez G, et al. Opioid-free anesthesia for lung cancer resection: a case-control study. J Cardiothorac Vasc Anesth. 2020;34:3036\u201340.","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"3497_CR2","doi-asserted-by":"publisher","first-page":"1959","DOI":"10.1007\/s00464-018-6477-5","volume":"33","author":"DS Keller","year":"2019","unstructured":"Keller DS, Zhang J, Chand M. Opioid-free colorectal surgery: a method to improve patient & financial outcomes in surgery. Surg Endosc. 2019;33:1959\u201366.","journal-title":"Surg Endosc"},{"key":"3497_CR3","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1097\/ALN.0000000000004840","volume":"140","author":"M L\u00e9ger","year":"2024","unstructured":"L\u00e9ger M, Perrault T, Pessiot-Royer S, et al. Opioid-free anesthesia protocol on the early quality of recovery after major surgery (SOFA trial): a randomized clinical trial. Anesthesiology. 2024;140:679\u201389.","journal-title":"Anesthesiology"},{"key":"3497_CR4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2021.110437","volume":"75","author":"C Massoth","year":"2021","unstructured":"Massoth C, Schwellenbach J, Saadat-Gilani K, et al. Impact of opioid-free anaesthesia on postoperative nausea, vomiting and pain after gynaecological laparoscopy - a randomised controlled trial. J Clin Anesth. 2021;75:110437.","journal-title":"J Clin Anesth"},{"key":"3497_CR5","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1097\/ACO.0000000000001385","volume":"37","author":"H Shanthanna","year":"2024","unstructured":"Shanthanna H, Joshi GP. Opioid-free general anesthesia: considerations, techniques, and limitations. Curr Opin Anaesthesiol. 2024;37:384\u201390.","journal-title":"Curr Opin Anaesthesiol"},{"key":"3497_CR6","doi-asserted-by":"publisher","first-page":"3041","DOI":"10.1053\/j.jvca.2020.07.022","volume":"34","author":"DK Tempe","year":"2020","unstructured":"Tempe DK, Sawhney C. Opioid-free anesthesia for thoracic surgery: a step forward. J Cardiothorac Vasc Anesth. 2020;34:3041\u20133.","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"3497_CR7","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11236955","volume":"11","author":"F D\u2019Amico","year":"2022","unstructured":"D\u2019Amico F, Barucco G, Licheri M, et al. Opioid free anesthesia in thoracic surgery: a systematic review and meta analysis. JCM. 2022;11:6955.","journal-title":"JCM"},{"key":"3497_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2023.111215","volume":"90","author":"ML Feenstra","year":"2023","unstructured":"Feenstra ML, Jansen S, Eshuis WJ, Van Berge Henegouwen MI, Hollmann MW, Hermanides J. Opioid-free anesthesia: a systematic review and meta-analysis. J Clin Anesth. 2023;90:111215.","journal-title":"J Clin Anesth"},{"key":"3497_CR9","doi-asserted-by":"publisher","first-page":"2280","DOI":"10.1016\/S0140-6736(22)00582-7","volume":"399","author":"JF Fiore","year":"2022","unstructured":"Fiore JF, El-Kefraoui C, Chay M-A, et al. Opioid versus opioid-free analgesia after surgical discharge: a systematic review and meta-analysis of randomised trials. Lancet. 2022;399:2280\u201393.","journal-title":"Lancet"},{"key":"3497_CR10","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10102069","volume":"10","author":"A Salom\u00e9","year":"2021","unstructured":"Salom\u00e9 A, Harkouk H, Fletcher D, Martinez V. Opioid-free anesthesia benefit\u2013risk balance: a systematic review and meta-analysis of randomized controlled trials. JCM. 2021;10:2069.","journal-title":"JCM"},{"key":"3497_CR11","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1097\/ALN.0000000000003725","volume":"134","author":"H Beloeil","year":"2021","unstructured":"Beloeil H, Garot M, Lebuffe G. Balanced opioid-free anesthesia with dexmedetomidine versus balanced anesthesia with remifentanil for major or intermediate noncardiac surgery. Anesthesiology. 2021;134:541\u201351.","journal-title":"Anesthesiology"},{"key":"3497_CR12","doi-asserted-by":"publisher","first-page":"e1652","DOI":"10.1212\/WNL.0000000000007238","volume":"92","author":"T Thompson","year":"2019","unstructured":"Thompson T, Whiter F, Gallop K, et al. NMDA receptor antagonists and pain relief: a meta-analysis of experimental trials. Neurology. 2019;92:e1652-62.","journal-title":"Neurology"},{"key":"3497_CR13","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1213\/ANE.0b013e3182662e01","volume":"115","author":"MV Grady","year":"2012","unstructured":"Grady MV, Mascha E, Sessler DI, Kurz A. The effect of perioperative intravenous lidocaine and ketamine on recovery after abdominal hysterectomy. Anesth Analg. 2012;115:1078\u201384.","journal-title":"Anesth Analg"},{"key":"3497_CR14","doi-asserted-by":"publisher","unstructured":"Santonastaso DP. Thoracic paravertebral block and awake surgery: a prospective observational study. Tumori Journal. 2020;107(2):125-31. https:\/\/doi.org\/10.1177\/0300891620951626.","DOI":"10.1177\/0300891620951626"},{"key":"3497_CR15","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-022-01747-w","volume":"22","author":"G An","year":"2022","unstructured":"An G, Wang G, Zhao B, et al. Opioid-free anesthesia compared to opioid anesthesia for laparoscopic radical colectomy with pain threshold index monitoring: a randomized controlled study. BMC Anesthesiol. 2022;22:241.","journal-title":"BMC Anesthesiol"},{"key":"3497_CR16","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1213\/ANE.0000000000006942","volume":"140","author":"Y Ao","year":"2025","unstructured":"Ao Y, Ma J, Zheng X, Zeng J, Wei K. Opioid-sparing anesthesia versus opioid-free anesthesia for the prevention of postoperative nausea and vomiting after laparoscopic bariatric surgery: a systematic review and network meta-analysis. Anesth Analg. 2025;140:385\u201396.","journal-title":"Anesth Analg"},{"key":"3497_CR17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-079544","volume":"14","author":"R Bao","year":"2024","unstructured":"Bao R, Zhang W, Zha Y, et al. Effects of opioid-free anaesthesia compared with balanced general anaesthesia on nausea and vomiting after video-assisted thoracoscopic surgery: a single-centre randomised controlled trial. BMJ Open. 2024;14:e079544.","journal-title":"BMJ Open"},{"key":"3497_CR18","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.bja.2023.11.008","volume":"132","author":"C Feng","year":"2024","unstructured":"Feng C, Xu Y, Chen S, et al. Opioid-free anaesthesia reduces postoperative nausea and vomiting after thoracoscopic lung resection: a randomised controlled trial. Br J Anaesth. 2024;132:267\u201376.","journal-title":"Br J Anaesth"},{"key":"3497_CR19","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s40122-019-0122-4","volume":"8","author":"M Raff","year":"2019","unstructured":"Raff M, Belbachir A, El-Tallawy S, et al. Intravenous oxycodone versus other intravenous strong opioids for acute postoperative pain control: a systematic review of randomized controlled trials. Pain Ther. 2019;8:19\u201339.","journal-title":"Pain Ther"},{"key":"3497_CR20","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-025-02938-x","volume":"25","author":"X Yan","year":"2025","unstructured":"Yan X, Liang C, Jiang J, Ji Y, Wu A-S, Wei C-W. Effects of balanced opioid-free anesthesia on post-operative nausea and vomiting in patients undergoing video-assisted thoracic surgery: a randomized trial. BMC Anesthesiol. 2025;25:62.","journal-title":"BMC Anesthesiol"},{"key":"3497_CR21","doi-asserted-by":"publisher","first-page":"e0257279","DOI":"10.1371\/journal.pone.0257279","volume":"16","author":"G An","year":"2021","unstructured":"An G, Zhang Y, Chen N, Fu J, Zhao B, Zhao X. Opioid-free anesthesia compared to opioid anesthesia for lung cancer patients undergoing video-assisted thoracoscopic surgery: A randomized controlled study. PLoS ONE Edited Putzu A. 2021;16:e0257279.","journal-title":"PLoS ONE Edited Putzu A"},{"key":"3497_CR22","doi-asserted-by":"publisher","first-page":"2627","DOI":"10.1007\/s00204-021-03068-2","volume":"95","author":"BA Baldo","year":"2021","unstructured":"Baldo BA. Toxicities of opioid analgesics: respiratory depression, histamine release, hemodynamic changes, hypersensitivity, serotonin toxicity. Arch Toxicol. 2021;95:2627\u201342.","journal-title":"Arch Toxicol"},{"key":"3497_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-024-02441-9","volume":"24","author":"S Zhang","year":"2024","unstructured":"Zhang S, Zhang J, Zhang R. Safety and effectiveness of opioid-free anaesthesia in thoracoscopic surgery: a preliminary retrospective cohort study. BMC Anesthesiol. 2024;24:60.","journal-title":"BMC Anesthesiol"},{"key":"3497_CR24","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1111\/anae.15952","volume":"78","author":"LM Hughes","year":"2023","unstructured":"Hughes LM, Irwin MG, Nestor CC. Alternatives to remifentanil for the analgesic component of total intravenous anaesthesia: a narrative review. Anaesthesia. 2023;78:620\u20135.","journal-title":"Anaesthesia"},{"key":"3497_CR25","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v18i4.48","volume":"18","author":"MO Okello","year":"2018","unstructured":"Okello MO, Mung\u2019ayi V, Adam R, Kabugi J. A comparison of risk of hypotension using standard doses of remifentanil versus dexmedetomidine infusions in adult patients undergoing surgery under general anaesthesia at the Aga Khan university hospital, Nairobi. Afr Health Sci. 2018;18:1267.","journal-title":"Afr Health Sci"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03497-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-025-03497-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03497-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:51:50Z","timestamp":1765536710000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12871-025-03497-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3497"],"URL":"https:\/\/doi.org\/10.1186\/s12871-025-03497-x","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7443836\/v1","asserted-by":"object"}]},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]},"assertion":[{"value":"24 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This randomized controlled trial was approved by the Ethics Committee of Peking University People\u2019s Hospital (approval number: 2020PHB031-01, 16\/07\/2020, Chairman: Kaiyan Liu). The study followed the Declaration of Helsinki and the CONSORT guidelines (supplementary materials). All included patients signed informed consent forms. No modifications were made to the study protocol during its implementation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"607"}}