A Multicentre Cluster Randomised Stepped Wedge Trial of Opioid Sparing Analgesia in Emergency General Surgery.

Randomized trialANZ journal of surgery· Aug 2026

A Multicentre Cluster Randomised Stepped Wedge Trial of Opioid Sparing Analgesia in Emergency General Surgery.

Chao Ren, Shicao Li, Tian Zhang, Jing Ding

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Trauma & Acute Care SurgeryRandomized trialTreatmentQ2IF 1.0

Multimodal opioid-sparing pathway cut 48-hour postoperative opioid use in emergency surgery

A Multicentre Cluster Randomised Stepped Wedge Trial of Opioid Sparing Analgesia in Emergency General Surgery.

Chao Ren … Jing Ding

ANZ journal of surgery · Aug 2026 · Q2 in Surgery

Background

Emergency general surgery (emergency general surgery) is associated with high postoperative pain burden and historically relies on opioid-centric analgesia, which can delay recovery and increase opioid-related adverse events and longer-term exposure.

Methods

We conducted a pragmatic, multicentre and cluster-randomised stepped-wedge trial in 12 Chinese tertiary hospitals comparing usual care with a structured multimodal opioid-sparing perioperative analgesia pathway.

Results

48-hour opioid use fell after the pathway, less pain medication needed

More results

Of 3646 enrolled patients, primary outcome data were available for 3561 (97.7%).

Pain burden, recovery metrics, opioid-related adverse events and persistent opioid use at 30 days all favoured the intervention.

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Conclusion

A structured opioid-sparing pathway reduced early postoperative opioid exposure and improved recovery and safety outcomes in emergency general surgery, supporting wider implementation of multimodal opioid stewardship.

A Multicentre Cluster Randomised Stepped Wedge Trial of Opioid Sparing Analgesia in Emergency General Surgery.

A Multicentre Cluster Randomised Stepped Wedge Trial of Opioid Sparing Analgesia in Emergency General Surgery.

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