The effect of opioid-free anaesthesia on pain and prognosis in gynaecological laparoscopic surgery: a systematic review and meta-analysis

Abstract

Background: To evaluate the effect of opioid-free anaesthesia on postoperative pain and prognosis in gynaecological laparoscopic surgery. Methods: A systematic search of four English and four Chinese databases was conducted up to 31 January 2024. Ten randomised controlled trials involving 861 patients were included. Results: Opioid-free anaesthesia substantially reduced the incidence of postoperative nausea and vomiting (odds ratio = 0.25), lowered pain scores measured by numeric rating scale (mean difference = −1.43) and Visual Analog Scale (mean differenc = −1.50), improved Quality of Recovery-40 scores (mean differenc = 15.39) and shortened the hospital stay (length of hospital stay) (mean differenc = −1.72). Sensitivity analysis confirmed the robustness of most outcomes. Conclusion: Opioid-free anaesthesia improves postoperative pain control and recovery in patients who undergo gynaecological laparoscopic surgery. It effectively reduces postoperative nausea and vomiting and enhances recovery quality, suggesting that opioid-free anaesthesia may be a promising alternative to opioid-based anaesthesia.