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Total opioid-free g...
Total opioid-free general anaesthesia can improve postoperative outcomes after surgery, without evidence of adverse effects on patient safety and pain management : a systematic review and meta-analysis
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- Olausson, Alexander (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences
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- Svensson, Carl Johan, 1976 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
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- Andréll, Paulin, 1978 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
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- Jildenstål, Pether, 1970- (författare)
- Gothenburg University,Göteborgs universitet,Lund University,Lunds universitet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Institute for Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Anesthesia, Operation & Intensive Care, Sahlgrenska University Hospital / Östra, Region Västra Götaland, Gothenburg, Sweden; Department of Anaesthesia, Operation & Intensive Care, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden; Department of Health Sciences, Lund University, Lund, Sweden; Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden,Hälsa i ett tvärvetenskapligt perspektiv,Forskargrupper vid Lunds universitet,Integrative Health Research,Lund University Research Groups,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences
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- Thörn, Sven Egron, 1954 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
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- Wolf, Axel (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences
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(creator_code:org_t)
- 2021-11-11
- 2022
- Engelska.
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley-Blackwell Publishing Inc.. - 0001-5172 .- 1399-6576. ; 66:2, s. 170-185
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https://doi.org/10.1...
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http://dx.doi.org/10... (free)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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https://gup.ub.gu.se...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Opioid-based treatment is used to manage stress responses during surgery and postoperative pain. However, opioids have both acute and long-term side-effects, calling for opioid-free anaesthetic strategies. This meta-analysis compares adverse events, postoperative recovery, discharge time from post-anaesthesia care unit, and postoperative pain, nausea, vomiting, and opioid consumption between strict opioid-free with opioid-based general anaesthesia.METHODS: We conducted a systematic review and meta-analysis. We searched PubMed, Embase, Cinahl, Cochrane Library, selected reference lists, and Google Scholar. We included randomised controlled trials (RCTs) published between January 2000 and February 2021 with at least one opioid-free study arm, i.e. no opioids administered preoperatively, during anaesthesia induction, before skin closure, or before emergence from anaesthesia.RESULTS: The study comprised 1934 patients from 26 RCTs. Common interventions included laparoscopic gynaecological surgery, upper gastrointestinal surgery, and breast surgery. There is firm evidence that opioid-free anaesthesia significantly reduced adverse post-operative events (OR 0.32, 95% CI 0.22 to 0.46, I2 =56%, p<0.00001), mainly driven by decreased nausea (OR 0.27, (0.17 to 0.42), p<0,00001) and vomiting (OR 0.22 (0.11 to 0.41), p<0.00001). Postoperative opioid consumption was significantly lower in the opioid-free group (-6.00 mg (-8.52 to -3.48), p<0.00001). There was no significant difference in length of post-anaesthesia care unit stay and overall postoperative pain between groups.CONCLUSIONS: Opioid-free anaesthesia can improve postoperative outcomes in several surgical settings without evidence of adverse effects on patient safety and pain management. There is a need for more evidence-based non-opioid anaesthetic protocols for different types of surgery as well as postoperative phases.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Adverse events
- OFA
- Opioid consumption
- Opioid-free anaesthesia
- Postoperative nausea and vomiting
- Postoperative pain
- Recovery
- adverse events
- OFA
- opioid consumption
- opioid-free anaesthesia
- postoperative nausea and vomiting
- postoperative pain
- recovery
Publikations- och innehållstyp
- ref (ämneskategori)
- for (ämneskategori)
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