Opioid-free anesthesia for quality of recovery score after surgery: A meta-analysis of randomized controlled trials.

Background: This meta-analysis aimed to evaluate the impact of opioid-free anesthesia (OFA) on the postoperative subjective quality of recovery (QoR).

Methods: Our comprehensive literature search, spanning PubMed, Embase, Cochrane Library, and Google Scholar, targeted clinical trials that evaluated the effects of OFA versus opioid-based anesthesia (OBA) on postoperative QoR. The data were analyzed using Review Manager, STATA, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) profiler.

Results: This meta-analysis included 13 randomized controlled trials (RCTs). OFA significantly improved the QoR-15 score (SMD 2.16; 95 % CI 0.13-4.20; I2 = 98 %; 293 patients in 3 trials) and QoR-40 score (SMD 0.47; 95 % CI 0.18-0.77; I2 = 82 %; 1464 patients in 236 trials). Furthermore, the incidence of nausea, vomiting, and hypotension was reduced, with no difference in the risk of bradycardia or time for extubation of the trachea.

Conclusions: This meta-analysis shows OFA improves early postoperative quality of recovery and reduces the occurrence of nausea, vomiting, and hypotension without increasing the risk of bradycardia or prolonging the time for extubation of the trachea.