Table 1: Trial characteristics.
|
Reference |
Study design |
Group (n) |
Surgery |
Control Group |
Opioid regimen |
Anaesthetic Maintenance |
Postoperative analgesia |
Primary Outcome |
|
|
|
|||||||||
|
OBA |
OFA |
||||||||
|
Bakan M, et al. [27] |
Randomized Controlled Trial |
Opioid-free (40) |
Laparoscopic cholecystectomy |
Normal saline |
Fentanyl induction dose (2 μg/kg) + Remifentanil infusion (0.25 μg/kg/min) |
Dexmedetomidine [loading dose (0.6 μg/kg) + infusion (0.3 μg/kg/h)] + Lidocaine (2 mg/kg/h) |
Propofol |
PCA of Fentanyl i.v. |
Fentanyl consumption used for pain relief in the first 6h. |
|
Choi E, et al. [28] |
Randomized Controlled Trial |
Opioid-free (40) |
Thyroidectomy |
None |
Remifentanil 2-4 ng/ml (TCI) |
Dexmedetomidine [loading dose (1 μg/kg) + infusion (0.3-0.5 μg/kg/h)] |
Sevoflurane |
Ketorolac i.v. |
Not specified |
|
Elsaye R, et al. [24] |
Randomized Controlled Trial |
Opioid-free (20) |
Laparoscopic cholecystectomy |
None |
Fentanyl induction dose (1-2 μg/kg) + intermittent boluses (50 mic) |
Dexmedetomidine [loading dose (0.5 μg/kg) + infusion (0.25 μg/kg/h)] + Lidocaine [bolus dose (1 mg/kg) + infusion (1 mg/kg/h)] + Magnesium sulfate [loading dose (30 mg/kg) + infusion (10 mg/kg/h)] |
Desflurane |
Pethidinei.m. |
Compare OBA with OFA on postoperative pain relief |
|
Frauenknecht J, et al. [29] |
Meta-analysis |
Total (1304) |
Any surgical operation |
NA |
NA |
NA |
NA |
NA |
Pain score at rest at 2 postoperative hours |
|
Grape S, et al. [30] |
Meta-analysis |
Total (1309) |
Any surgical operation |
NA |
NA |
NA |
NA |
NA |
Pain score at rest at 2 postoperative hours |
|
Hontoir S, et al. [31] |
Randomized Controlled Trial |
Opioid-free (31) |
Breast cancer surgery |
None |
Remifentanil DNM (TCI) |
Clonidine [loading dose (0.2 μg/kg)] + Ketamine bolus dose (0.2 mg/kg) if necessary |
Sevoflurane |
Paracetamoli.v.+ Diclofenaci.v. + PCA of piritramidei.v. |
Postoperative patient comfort assessed by QoR-40 questionnaire |
|
Karabayirli S, et al. [32] |
Randomized Controlled Trial |
Opioid-free (23) |
Functional endoscopic sinus surgery |
None |
Remifentanil [loading dose (1 μg/kg) + infusion (0.25-0.50 μg/kg/min)] |
Dexmedetomidine [loading dose (1 μg/kg) + infusion (0.7 μg/kg/h)] |
Sevoflurane |
Paracetamoli.v. |
Not specified |
|
Mulier J, et al. [33] |
Randomized Controlled Trial |
Opioid-free (23) |
Laparoscopic bariatric surgery |
None |
Sufentanil [bolus dose (0.5 mg/kg) + infusion (0.25-1 mg/kg/h)] |
Dexmedetomidine [loading dose (0.5 μg/kg) + infusion (0.25 - 1 μg /kg/h)] + Lidocaine [bolus dose (1.5 mg/kg) + infusion (1.5 - 3 mg/kg/h)] + Ketamine bolus dose (0.25 mg/kg) |
Sevoflurane |
Paracetamoli.v. + PCA of morphine i.v. |
Not specified |
|
Salem A, et al. [34] |
Prospective Clinical Trial |
Opioid-free (36) |
Laparoscopic hysterectomy |
Normal saline |
Fentanyl induction dose (2 μg/kg) + Remifentanil infusion (0.25 μg/kg/min) |
Dexmedetomidine [loading dose (0.6 μg/kg) + infusion (1 μg /kg/h)] + Lidocaine [bolus dose (1.5 mg/kg) + infusion (DNM)] |
Propofol |
Parecoxib |
Frequency of IO deviated MAP measures and necessity of interference. |
|
Shalaby M, et al. [35] |
Randomized Controlled Trial |
Opioid-free (40) |
Laparoscopic cholecystectomy |
None |
Fentanyl [induction dose (1 μg/kg) + infusion (0,4 μg/kg/h)] |
Dexmedetomidine [loading dose (1 μg/kg) + infusion (0.5 μg/kg/h)] |
Isoflurane |
NM |
Not specified |
|
Singh P, et al. [36] |
Meta-analysis |
Total (362) |
Bariatric Surgery |
NA |
NA |
NA |
NA |
NA |
24 postoperative hours morphine consumption |
NA: Not applicable; DNM: Dose not mentioned; NM: Not mentioned; OBA: Opioid-based anaesthesia; OFA: Opioid-free anaesthesia; DNM: Dose not mentioned; QoR: Quality of recovery; IO: Intraoperative; MAP: Mean arterial pressure.