Opioid‐free vs. opioid‐inclusive anaesthesia with or without regional anaesthesia for postoperative pain: a systematic review with network meta‐analysis of randomised controlled trials

Concerns about opioid-related adverse effects have increased interest in opioid-free anaesthesia, but the benefits compared with opioid-inclusive techniques, especially in the presence of regional anaesthesia, remain uncertain.

We undertook a systematic review with a network meta-analysis of randomised controlled trials comparing six strategies in adults: opioid-free anaesthesia and opioid-inclusive anaesthesia using remifentanil alone or other opioids, each with or without regional anaesthesia. Primary outcome was postoperative pain. Secondary outcomes were: postoperative opioid use; post-anaesthesia care unit discharge time; hospital duration of stay; and incidence of complications.