Research Progress on the Clinical Application of Opioid-Free Anesthesia
DOI:
https://doi.org/10.18063/apm.v10i2.899Keywords:
Opioid-free anesthesia, Indications, Clinical valueAbstract
Opioid-free anesthesia (OFA) is an innovative anesthetic strategy that minimizes intraoperative opioid use by employing multimodal analgesia, including regional techniques, non-opioid analgesics, and nerve blocks, while ensuring perioperative safety and effective pain control. Current studies suggest that OFA offers potential advantages in reducing opioid-related complications, improving long-term prognosis, and shortening postoperative recovery time. However, further research is needed to explore its long-term benefits and optimal patient populations. This article summarizes the classifications and indications of OFA and reviews its clinical value in gynecological, thoracic, orthopedic, and geriatric surgeries.
References
Deng D, Lin G, Wang D, et al., 2024, Research Progress on the Clinical Application of Opioid-Free Anesthesia. Chongqing Medicine, 53(19): 3018–3023 + 3028.
Wang K, Zhou W, Cheng C, et al., 2024, Advances in the Application of Opioid-Free Anesthesia in Tumor Surgery. Journal of Modern Oncology, 32(16): 3150–3155.
Wu G, Xie H, Luo Y, et al., 2023, Clinical Effect of Opioid-Free General Anesthesia in Subtotal Thyroidectomy. Guangxi Medical Journal, 45(12): 1499–1503.
Zhao K, Wang C, 2023, Clinical Observation of Ciprofol Combined with Esketamine in Opioid-Free Anesthesia for Painless Colonoscopy. Beijing Medical Journal, 45(11): 962–966.
Li W, Zhang W, Xie H, et al., 2024, Effects of Opioid-Free General Anesthesia on Perioperative Pain and Immune Function in Breast Cancer Surgery Patients. Chinese Journal of Endocrine Surgery, 18(2): 217–221.
Zhao K, Wang C, 2024, Application of Esketamine Combined with Ciprofol in Opioid-Free Anesthesia for Colonoscopy in Elderly Patients. China Journal of Endoscopy, 30(3): 66–72.
Chen J, Wang X, Tang C, et al., 2024, Analgesic Effect of Magnesium Sulfate and Its Application Prospects in Opioid-Free Anesthesia Protocols. Herald of Medicine, 43(10): 1651–1655.
Liu F, Wang G, Li Y, et al., 2024, Dexmedetomidine-Based Opioid-Free Balanced Anesthesia in Non-Transected Roux-en-Y Gastrojejunostomy for Digestive Tract Reconstruction. Chinese Journal of Laboratory Diagnosis, 28(6): 637–642.
Xu T, Sun W, Chen X, et al., 2023, Effects of Esketamine-Based Opioid-Free General Anesthesia on Neurogenic Inflammatory Factors, Cerebral Oxygen Metabolism, and Anesthesia Recovery Quality in Elderly Patients Undergoing Total Hip Arthroplasty. Translational Medicine Journal, 12(6): 350–356.
Shi T, Tian J, Wang X, et al., 2022, Application of Low-Dose Esketamine Combined with Flurbiprofen Axetil in Opioid-Sparing Anesthesia During Perioperative Period of Radical Mastectomy. Chinese Journal of Modern Operative Surgery, 26(5): 406–411.
Chen Y, Zhang Y, Shi B, et al., 2025, Optimization Strategy for Anesthesia in Modified Radical Mastectomy: Thoracic Paravertebral Nerve Block-Opioid-Free Anesthesia. Chinese Journal of Modern General Surgery, 28(2): 114–118.
Liu M, He L, Tian D, et al., 2023, Effects of Esketamine Combined with Dexmedetomidine for Opioid-Free Anesthesia on Postoperative Recovery Quality in Patients Undergoing Modified Radical Mastectomy. Journal of Zhengzhou University (Medical Sciences), 58(3): 363–366.
Shi P, 2022, Effect of Opioid-Free Anesthesia on Postoperative Complications in Patients Undergoing Radical Esophagectomy. Journal of Clinical Rational Drug Use, 15(5): 81–83.
Liu K, Ye W, Zheng G, et al., 2021, Application of Opioid-Free Anesthesia in Non-Intubated Thoracoscopic Surgery. China Journal of Modern Medicine, 31(17): 46–51.
Xu T, Cheng X, Guo J, et al., 2024, Application of Periarticular Infiltration Analgesia Combined with Opioid-Free General Anesthesia in Total Hip Arthroplasty. Journal of Xinjiang Medical University, 47(6): 843–848 + 853.
Chen Q, Wu B, 2023, Clinical Study of Opioid-Free Analgesia Protocol in Calcaneal Fracture Surgery. Systems Medicine, 8(3): 51–54.
Zhou B, Yu Y, Qiu Z, et al., 2022, Application of Esketamine in Opioid-Free General Anesthesia Induction for Elderly Patients. Chinese Journal of New Drugs and Clinical Remedies, 41(3): 162–166.
Torre A, Marengo M, Ledingham N, et al., 2022, Opioid-Free Anesthesia in Bariatric Surgery: A Propensity Score-Matched Analysis. Obesity Surgery, 32(5): 1673–1680.
Liu Z, Bi C, Li X, et al., 2023, The Efficacy and Safety of Opioid-Free Anesthesia Combined with Ultrasound-Guided Intermediate Cervical Plexus Block vs. Opioid-Based Anesthesia in Thyroid Surgery – A Randomized Controlled Trial. Journal of Anesthesia, 37(6): 914–922.
Yan H, Chen W, Chen Y, et al., 2023, Opioid-Free Versus Opioid-Based Anesthesia on Postoperative Pain After Thoracoscopic Surgery: The Use of Intravenous and Epidural Esketamine. Anesthesia and Analgesia: Journal of the International Anesthesia Research Society, 137(2): 399–408.
