To synthesize current evidence on the efficacy and safety of opioid-free anesthesia (OFA) and explore practical challenges of its implementation.
Key Findings:
OFA significantly reduces postoperative nausea and vomiting (PONV).
Analgesia and recovery outcomes with OFA are comparable to OBA.
Hemodynamic stability varies; dexmedetomidine-based regimens may cause increased bradycardia and hypotension.
PACU stay duration varies, with OFA leading to both shorter and longer stays.
Limited long-term outcome data exists.
Interpretation:
OFA is a viable alternative to OBA, effectively reducing PONV while maintaining similar pain control and recovery times, though variability in protocols and outcomes exists.
Limitations:
Heterogeneous protocols across studies.
Small sample sizes in many trials.
Scarcity of long-term data affecting external validity.
Conclusion:
OFA is feasible and beneficial in reducing PONV, but further large, multicenter trials are necessary to standardize protocols and clarify long-term outcomes.
