Can Opioid-Free Anaesthesia Be Personalised?: A Narrative Review

Jenna Goff; Morgan Hina; Nayaab Malik; Hannah McLardy; Finley Reilly; Matthew Robertson; Louis Ruddy; Faith Willox; Patrice Forget

doi:10.3390/jpm13030500

Can Opioid-Free Anaesthesia Be Personalised? A Narrative Review

Jenna Goff, Morgan Hina, Nayaab Malik, Hannah McLardy, Finley Reilly, Matthew Robertson^* (Corresponding Author), Louis Ruddy, Faith Willox, Patrice Forget

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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Abstract

BACKGROUND: A significant amount of evidence suggests that Opioid-Free Anaesthesia (OFA) may provide better outcomes for patients undergoing surgery, sparing patients who are particularly vulnerable to adverse side effects of opioids. However, to what extent personalizing OFA is feasible and beneficial has not been adequately described.

METHODS: We conducted a narrative literature review aiming to provide a comprehensive understanding of nociception and pain and its context within the field of OFA. Physiological (including monitoring), pharmacological, procedural (type of surgery), genetical and phenotypical (including patients' conditions) were considered.

RESULTS: We did not find any monitoring robustly associated with improved outcomes. However, we found evidence supporting particular OFA indications, such as bariatric and cancer surgery. We found that vulnerable patients may benefit more from OFA, with an interesting field of research in patients suffering from vascular disease. We found a variety of techniques and medications making it impossible to consider OFA as a single technique. Our findings suggest that a vast field of research remains unexplored. In particular, a deeper understanding of nociception with an interest in its genetic and acquired contributors would be an excellent starting point paving the way for personalised OFA.

CONCLUSION: Recent developments in OFA may present a more holistic approach, challenging the use of opioids. Understanding better nociception, given the variety of OFA techniques, may help to maximize their potential in different contexts and potential indications.

Original language	English
Journal	Journal of Personalized Medicine
Volume	13
Issue number	3
DOIs	https://doi.org/10.3390/jpm13030500
Publication status	Published - 10 Mar 2023

Bibliographical note

Acknowledgments
The authors would like to thank Marc De Kock for his contribution to the conceptualization of this work.

Data Availability Statement

Not applicable

Keywords

opioids
Opioid-free anaesthesia
personalised anaesthesia

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

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title = "Can Opioid-Free Anaesthesia Be Personalised?: A Narrative Review",

abstract = "BACKGROUND: A significant amount of evidence suggests that Opioid-Free Anaesthesia (OFA) may provide better outcomes for patients undergoing surgery, sparing patients who are particularly vulnerable to adverse side effects of opioids. However, to what extent personalizing OFA is feasible and beneficial has not been adequately described.METHODS: We conducted a narrative literature review aiming to provide a comprehensive understanding of nociception and pain and its context within the field of OFA. Physiological (including monitoring), pharmacological, procedural (type of surgery), genetical and phenotypical (including patients' conditions) were considered.RESULTS: We did not find any monitoring robustly associated with improved outcomes. However, we found evidence supporting particular OFA indications, such as bariatric and cancer surgery. We found that vulnerable patients may benefit more from OFA, with an interesting field of research in patients suffering from vascular disease. We found a variety of techniques and medications making it impossible to consider OFA as a single technique. Our findings suggest that a vast field of research remains unexplored. In particular, a deeper understanding of nociception with an interest in its genetic and acquired contributors would be an excellent starting point paving the way for personalised OFA.CONCLUSION: Recent developments in OFA may present a more holistic approach, challenging the use of opioids. Understanding better nociception, given the variety of OFA techniques, may help to maximize their potential in different contexts and potential indications.",

keywords = "opioids, Opioid-free anaesthesia, personalised anaesthesia",

author = "Jenna Goff and Morgan Hina and Nayaab Malik and Hannah McLardy and Finley Reilly and Matthew Robertson and Louis Ruddy and Faith Willox and Patrice Forget",

note = "Acknowledgments The authors would like to thank Marc De Kock for his contribution to the conceptualization of this work.",

year = "2023",

month = mar,

day = "10",

doi = "10.3390/jpm13030500",

language = "English",

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TY - JOUR

T1 - Can Opioid-Free Anaesthesia Be Personalised?

T2 - A Narrative Review

AU - Goff, Jenna

AU - Hina, Morgan

AU - Malik, Nayaab

AU - McLardy, Hannah

AU - Reilly, Finley

AU - Robertson, Matthew

AU - Ruddy, Louis

AU - Willox, Faith

AU - Forget, Patrice

N1 - Acknowledgments The authors would like to thank Marc De Kock for his contribution to the conceptualization of this work.

PY - 2023/3/10

Y1 - 2023/3/10

N2 - BACKGROUND: A significant amount of evidence suggests that Opioid-Free Anaesthesia (OFA) may provide better outcomes for patients undergoing surgery, sparing patients who are particularly vulnerable to adverse side effects of opioids. However, to what extent personalizing OFA is feasible and beneficial has not been adequately described.METHODS: We conducted a narrative literature review aiming to provide a comprehensive understanding of nociception and pain and its context within the field of OFA. Physiological (including monitoring), pharmacological, procedural (type of surgery), genetical and phenotypical (including patients' conditions) were considered.RESULTS: We did not find any monitoring robustly associated with improved outcomes. However, we found evidence supporting particular OFA indications, such as bariatric and cancer surgery. We found that vulnerable patients may benefit more from OFA, with an interesting field of research in patients suffering from vascular disease. We found a variety of techniques and medications making it impossible to consider OFA as a single technique. Our findings suggest that a vast field of research remains unexplored. In particular, a deeper understanding of nociception with an interest in its genetic and acquired contributors would be an excellent starting point paving the way for personalised OFA.CONCLUSION: Recent developments in OFA may present a more holistic approach, challenging the use of opioids. Understanding better nociception, given the variety of OFA techniques, may help to maximize their potential in different contexts and potential indications.

AB - BACKGROUND: A significant amount of evidence suggests that Opioid-Free Anaesthesia (OFA) may provide better outcomes for patients undergoing surgery, sparing patients who are particularly vulnerable to adverse side effects of opioids. However, to what extent personalizing OFA is feasible and beneficial has not been adequately described.METHODS: We conducted a narrative literature review aiming to provide a comprehensive understanding of nociception and pain and its context within the field of OFA. Physiological (including monitoring), pharmacological, procedural (type of surgery), genetical and phenotypical (including patients' conditions) were considered.RESULTS: We did not find any monitoring robustly associated with improved outcomes. However, we found evidence supporting particular OFA indications, such as bariatric and cancer surgery. We found that vulnerable patients may benefit more from OFA, with an interesting field of research in patients suffering from vascular disease. We found a variety of techniques and medications making it impossible to consider OFA as a single technique. Our findings suggest that a vast field of research remains unexplored. In particular, a deeper understanding of nociception with an interest in its genetic and acquired contributors would be an excellent starting point paving the way for personalised OFA.CONCLUSION: Recent developments in OFA may present a more holistic approach, challenging the use of opioids. Understanding better nociception, given the variety of OFA techniques, may help to maximize their potential in different contexts and potential indications.

KW - opioids

KW - Opioid-free anaesthesia

KW - personalised anaesthesia

U2 - 10.3390/jpm13030500

DO - 10.3390/jpm13030500

M3 - Review article

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SN - 2075-4426

VL - 13

JO - Journal of Personalized Medicine

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ER -