Key result
Opioid-free anesthesia in orthopedic surgery provides comparable acute pain control to traditional opioid regimens while reducing postoperative nausea, vomiting, and respiratory depression.
Why the study?
Orthopedic surgery patients are at high risk for acute and chronic pain, but the complete perioperative avoidance of opioids remains controversial.
This article reviews the theoretical basis, implementation protocols, effectiveness, safety, and limitations of opioid-free anesthesia in orthopedic surgery.
Supports cautious multimodal opioid-free approaches in orthopedic ERAS; leaves open need for RCTs on safety and efficacy.
随着加速康外科学理念(ERAS)的提出及多模式镇痛的发展，无阿片麻醉在非阿片类药物和技术的进步下得到进一步完善。骨科手术患者作为急性疼痛和慢性疼痛的高危人群，减少阿片类药物的使用可显著降低相关风险，促进患者预后。然而目前学界对围术期完全避免使用阿片类药物尚存争议。本文从无阿片麻醉的相关理论基础及其在骨科手术中的实施方案、有效性、安全性、局限性等方面进行综述，为临床应用和开展进一步研究提供参考。With the introduction of the Accelerated Recovery Surgery Concept (ERAS) and the development of multimodal analgesia, opioid-free anesthesia has been further refined by advances in non-opioid medications and techniques. As orthopedic surgical patients are at high risk for both acute and chronic pain, reducing the use of opioids can significantly reduce the associated risks and promote patient prognosis. However, the complete avoidance of opioids in the perioperative period is currently controversial in the academic community. This article reviews the relevant theoretical basis of opioid-free anesthesia and its implementation protocols, effectiveness, safety, and limitations in orthopedic surgery to provide reference for clinical application and conducting further research.
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淑婷 仲 (2025) conducted a review in Orthopedic Surgery. Opioid-Free Anesthesia vs. Opioid-based anesthesia was evaluated. Opioid-free anesthesia in orthopedic surgery provides comparable acute pain control to traditional opioid regimens while reducing postoperative nausea, vomiting, and respiratory depression.
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