Impact of opioid-free anesthetic on postoperative complication following gynecological surgery: a meta-analysis.

A meta-analysis study was performed to scrutinize how opioid free anesthesia impact on the postoperative complication following gynecological surgery (GS). The 10 selected studies such as 852 females who underwent GS at the beginning of the study. Odds ratios (ORs) and mean differences (MDs) and 95% confidence intervals (CIs) were used to analyzed the effects of O-FA as compared to control treatment (opioid based anesthetic) on GS dichotomous or continuous methods using either a fixed or random effects model. The females undergoing GS, O-FA was associated with significantly lower postoperative nausea and vomiting (OR, 0.33; 95% CI, 0.24 - 0.46, p < 0.001), lower rescue antiemetic (OR, 0.32; 95% CI, 0.13 - 0.78, p = 0.01) and higher Quality of Recovery-40 (MD, 4.69; 95% CI, 2.48 - 6.90, p < 0.001) compared to control treatment. However, no significant difference was observed between in extubation (MD, - 0.61; 95% CI, -1.45 - 0.22, p = 0.15), postoperative pain score (MD, 0.49; 95% CI, -0.64-1.62, p = 0.39), and analgesic use (OR, 1.77; 95% CI, 0.57-5.50, p = 0.33) in females with GS. In females undergoing GS, O-FA resulted in significantly lower postoperative nausea and vomiting, reduced need for rescue antiemetic, and higher Quality of Recovery-40 compared to opioid-based anesthesia.