Opioid-Free Anesthesia Versus Opioid-Based Anesthesia for Video-Assisted Thoracoscopic Surgery: A Systematic Review...

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Evidence-Based Medicine

Background:

• Video-assisted thoracoscopic surgery (VATS) often involves significant postoperative pain and nausea.
• Opioid-based anesthesia (OA) is standard but associated with side effects.
• Opioid-free anesthesia (OFA) is an alternative approach aiming to mitigate these issues.

Purpose of the Study:

• To conduct a meta-analysis comparing opioid-free anesthesia (OFA) with opioid-based anesthesia (OA).
• To evaluate intraoperative and postoperative outcomes in patients undergoing VATS.
• To assess the efficacy and safety of OFA versus OA in VATS procedures.

Main Methods:

• Meta-analysis of randomized controlled trials (RCTs).
• Inclusion of 7 RCTs comprising 836 patients.
• Comparison of outcomes between OFA and OA groups in hospital settings.

Main Results:

• OFA significantly reduced the risk of postoperative nausea and vomiting (PONV) compared to OA.
• No significant differences were observed in resting or dynamic postoperative pain between OFA and OA.
• Postoperative opioid requirements, postanesthesia care unit length, and hospital stay did not differ significantly between the two anesthesia approaches.

Conclusions:

• OFA effectively reduces PONV incidence in VATS compared to OA.
• OFA does not significantly alter other key clinical outcomes like pain or hospital stay.
• OFA presents a valuable option for VATS, particularly for patients susceptible to PONV.