Application of opioid-free general anesthesia in laparoscopy: a meta-analysis of randomized controlled studies

Applying opioid-free general anesthesia (OFGA) in laparoscopy was controversial. A systematic review and meta-analysis were conducted to investigate the efficacy and safety of employing OFGA in laparoscopy. Relevant clinical trials to include in this systematic review and meta-analysis were scrutinized through electronic databases such as Embase, PubMed, Cochrane Library and Web of Science. The quality of selected randomized controlled trials (RCTs) was assessed by Cochrane Collaboration's bias risk assessment tool. The meta-analysis was conducted on Review Manager 5.3. The quality of evidence was assessed in accordance with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The analysis in this study included 14 RCTs involving 1042 patients. No notable variation examined in 24-hour postoperative pain score between the opioid-based and OFGA groups (mean difference = -0.43, 95% confidence interval (-1.08, 0.22); p = 0.19). However, OFGA application reduced the postoperative analgesic needs and the incidence of postoperative nausea and vomiting. The meta-analysis and systematic review findings indicated that OFGA could be effectively and safely used in laparoscopy.