Role of Opioid-Free Anesthesia Versus Opioid-Based Anesthesia in Postoperative Pain and Opioid Consumption…

ReviewJournal of clinical medicine· Jun 2026

Role of Opioid-Free Anesthesia Versus Opioid-Based Anesthesia in Postoperative Pain and Opioid Consumption: A Systematic Review and Meta-Analysis.

Akbota Ayazbekova, Abdurrehman Khan, Adina Yerzhan … Jacques E Chelly

Pain MedicineReviewTreatmentQ2IF 3.5

Opioid-free anesthesia linked to lower postoperative pain scores than opioid-based anesthesia

Role of Opioid-Free Anesthesia Versus Opioid-Based Anesthesia in Postoperative Pain and Opioid Consumption: A Systematic Review and Meta-Analysis.

Akbota Ayazbekova … Jacques E Chelly

Journal of clinical medicine · Jun 2026 · Q2 in General Medicine

Background

Opioid-free anesthesia (opioid-free anesthesia) has emerged as a potential alternative to opioid-based anesthesia (opioid-based anesthesia) to reduce opioid-related adverse effects.

Methods

Randomized controlled trials (randomized controlled trials) conducted on adult humans were selected; observational studies, studies including neuraxial anesthesia, and randomized controlled trials currently awaiting approval were excluded.

Results

opioid-free anesthesia gave lower pain scores, though effect was small and inconsistent across trials

Hedges' g -0.34 (95% CI -0.55 to -0.13)

null 0

-0.55

-0.13

CI excludes the null - significant

More results

Of 1446 citations found, twenty-nine articles met our inclusion criteria.

Twenty-six studies reported pain scores with a 0-10 scale.

Subgroup outcomes favored opioid-free anesthesia, with an overall reduction in pain found specifically in endoscopic abdominal surgeries.

More results

Some secondary outcomes also indicated potential improved recovery profiles through opioid-free anesthesia for certain surgeries.

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Conclusion · 1 of 2

Opioid-free anesthesia was associated with statistically significant lower postoperative pain scores, along with opioid consumption, but with a small effect size and high heterogeneity when compared to opioid-based anesthesia.

Conclusion · 2 of 2

This is potentially comparable in pain control and opioid consumption with limited clinical significance. Overall, outcomes support the continued controlled study of opioid-free anesthesia as an alternative to conventional analgesia.

Role of Opioid-Free Anesthesia Versus Opioid-Based Anesthesia in Postoperative Pain and Opioid Consumption: A Systematic Review and Meta-Analysis.

Role of Opioid-Free Anesthesia Versus Opioid-Based Anesthesia in Postoperative Pain and Opioid Consumption: A Systematic Review and Meta-Analysis.

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