Key result
Opioid-free anesthesia and multimodal analgesia in cardiac surgery reduce postoperative opioid consumption and improve pain control, though large-scale trials are needed to assess long-term outcomes.
Why the study?
Opioid-free anesthesia has emerged as an alternative in cardiac surgery to reduce opioid-related adverse effects while maintaining analgesia, but evidence on protocols and hemodynamic concerns requires examination.
Does opioid-free anesthesia and multimodal analgesia improve pain control and reduce opioid consumption in cardiac surgery patients?
Does opioid-free anesthesia and multimodal analgesia improve pain control and reduce opioid consumption in cardiac surgery patients?
Opioid-free anesthesia and multimodal analgesia offer a promising strategy to reduce opioid consumption and improve recovery in cardiac surgery, though intraoperative hemodynamic risks require careful management.
Answers are grounded in this paper and cite their sources.
May support OFA with multimodal agents in cardiac surgery; leaves open confirmation by RCTs.
Opioid-free anesthesia (OFA) has emerged as a promising alternative in cardiac surgery, aiming to reduce opioid-related adverse effects while maintaining effective perioperative analgesia. This narrative review examines current clinical evidence supporting OFA strategies, particularly the use of multimodal analgesia (MMA) incorporating agents such as dexmedetomidine, ketamine, lidocaine, magnesium, gabapentinoids, and Non-Steroidal Anti-inflammatory Drugs (NSAIDs). These regimens target multiple pain pathways to minimize reliance on opioids. Studies indicate that OFA can significantly reduce postoperative opioid consumption, improve pain control, decrease the incidence of nausea and vomiting, and enhance functional recovery outcomes. Despite these benefits, concerns remain regarding intraoperative hemodynamic stability, particularly the risks of bradycardia, hypotension, and delayed emergence. Current evidence supports the safety and efficacy of OFA and MMA in cardiac surgical settings, although large-scale, high-quality trials are still needed to standardize protocols and assess long-term outcomes. As the adoption of OFA and MMA expands, their integration into Enhanced Recovery After Surgery (ERAS) protocols may improve perioperative care and reduce opioid dependence in cardiac surgery patients.
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Rizqhan et al. (2025) conducted a review in Cardiac surgery. Opioid-free anesthesia (OFA) and multimodal analgesia (MMA) was evaluated. Opioid-free anesthesia and multimodal analgesia in cardiac surgery reduce postoperative opioid consumption and improve pain control, though large-scale trials are needed to assess long-term outcomes.
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