Redefiniendo la analgesia perioperatoria: impacto de la anestesia libre de opioides en cirugía de mama

IF 1.3 Q3 ANESTHESIOLOGY

Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI:10.1016/j.redar.2026.502048

Ó. Roca-Viéitez, J. Iglesias-López de Prado, P. Casas-Reza, M. Gestal-Vázquez, O. Sobrino-Robelo, P. Subirán-Rodríguez

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Abstract

Background and objectives

Opioid-free anesthesia (OFA) aims to achieve effective perioperative pain control while avoiding the adverse effects associated with opioid use. Its usefulness in breast surgery remains poorly studied. The primary objective of this study was to compare morphine consumption in the post-anesthesia care unit (PACU) between patients undergoing OFA and those receiving conventional opioid-based anesthesia.

Material and methods

A retrospective, observational, single-center study was conducted at the University Hospital of A Coruña. A total of 87 patients who underwent breast surgery between January and July 2022 were included. Two groups were compared: OFA (n = 41) and conventional opioid-based anesthesia (non-OFA, n = 46). The need for morphine rescue at PACU discharge, at 24 h, and at 48 h postoperatively (if patients remained hospitalized) was recorded. Secondary outcomes included the incidence of postoperative nausea and vomiting, oral tolerance, night rest, and length of stay in the PACU and hospital.

Results

The OFA group showed significantly lower morphine consumption in the recovery unit (9.8 vs. 47.8%; p < 0.001), with an absolute risk reduction of 38.1%. No postoperative nausea and vomiting events were observed in the OFA group compared with 21.7% in the non-OFA group (p = 0.001). Delayed oral tolerance was more frequent in the non-OFA group (0 vs. 15.2%; p = 0.013), and night rest was also better in the OFA group (94.4 vs. 65.7%; p < 0.05). No differences were found in PACU or hospital length of stay.

Discussion

The OFA technique provided adequate analgesic control with a significant reduction in postoperative adverse effects.

Conclusions

OFA in breast surgery is a safe and effective technique that improves postoperative recovery.

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重新定义围产期镇痛：无阿片麻醉对乳房手术的影响

背景与目的无阿片类药物麻醉（OFA）旨在有效控制围手术期疼痛，同时避免与阿片类药物使用相关的不良反应。它在乳房手术中的作用仍未得到充分研究。本研究的主要目的是比较OFA患者和接受常规阿片类药物麻醉的患者在麻醉后护理病房（PACU）的吗啡用量。材料与方法在A大学医院Coruña进行回顾性、观察性、单中心研究。共有87名患者在2022年1月至7月期间接受了乳房手术。两组比较：OFA （n = 41）和常规阿片类药物麻醉（非OFA， n = 46）。记录PACU出院时、术后24小时和术后48小时（如果患者仍住院）吗啡抢救的需要。次要结局包括术后恶心和呕吐的发生率、口服耐受性、夜间休息以及在PACU和医院的住院时间。结果OFA组在恢复单元吗啡用量显著降低（9.8 vs. 47.8%; p < 0.001），绝对风险降低38.1%。OFA组术后无恶心呕吐事件，而非OFA组为21.7% （p = 0.001）。非OFA组延迟口服耐受更常见（0比15.2%;p = 0.013）， OFA组夜间休息也更好（94.4比65.7%;p < 0.05）。PACU和住院时间均无差异。OFA技术提供了充分的镇痛控制，显著减少了术后不良反应。结论sofa是一种安全有效的乳房手术技术，可提高术后恢复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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