ArticleJournal of anesthesia, analgesia and critical care2021
Opioid-free anesthesia versus opioid-inclusive anesthesia for breast cancer surgery: a retrospective study.
Article in Journal of anesthesia, analgesia and critical care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed.
- A blended opioid-free anesthesia protocol and regional parietal blocks in laparoscopic abdominal surgery- a randomized controlled trial.Scientific reports · 2025Trial
- The efficacy and safety of an adapted opioid-free anesthesia regimen versus conventional general anesthesia in gynecological surgery for low-resource settings: a randomized pilot study.BMC anesthesiology · 2022Trial
- Effect of Opioid-Sparing Anesthesia on Postoperative Nausea and Vomiting After Breast Surgery: A Single-Center Randomized Controlled Trial.Journal of clinical medicine · 2026Article
- Clinical Efficacy and Risks of Clonidine Infusion for Sedation and Analgesia: A Narrative Review.Current pain and headache reports · 2026Review
- Intraoperative magnesium sulphate as an analgesic adjunct in a multimodal, opioid-sparing protocol for canine ovariohysterectomy: a prospective, randomized, controlled, double-blind study.Frontiers in veterinary science · 2026Article
- Postoperative nausea and vomiting: translating pathophysiological mechanisms into clinical management.Perioperative medicine (London, England) · 2025Review
- Opioid-free anesthesia with esketamine combined with interpectoral plane block and pectoralis-serratus plane blocks in radical mastectomy: a randomized controlled trial.Frontiers in pharmacology · 2025Article
- Review
- Dexmedetomidine as an Adjuvant to Nerve Block for Cancer Surgery: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Article
- Role of Magnesium in the Intensive Care Unit and Immunomodulation: A Literature Review.Vaccines · 2023Review
- Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBreast cancer surgery is usually managed using opioid-inclusive anesthesia (OIA), although opioids are associated with several adverse events, including nausea, vomiting, and constipation. Multimodal opioid-free anesthesia (OFA) has been introduced to reduce the incidence of these side effects. In this single-center retrospective study, we investigated whether ketamine, combined with magnesium and clonidine, could effectively control postoperative pain in patients undergoing quadrantectomy, while reducing postoperative nausea and vomiting (PONV).
resultsA total of 89 patients submitted to quadrantectomy were included and divided into an OFA group (38 patients) and an OIA group (51 patients) according to the received anesthetic technique. Analgesia in the OIA group was based on an intraoperative infusion of remifentanil, and analgesia in the OFA consisted of an intraoperative infusion of ketamine and magnesium sulfate. Postoperative pain in both groups was managed with nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol. Postoperative pain, assessed with the numeric rating scale (NRS), requirements for additional analgesics, the incidence of PONV, and patient satisfaction evaluated using a QoR-40 questionnaire were compared between the two groups. Levels of pain at 30 min and 6, 12, and 24 h after surgery; number of paracetamol rescue doses; and the incidence of PONV were lower in the OFA group (p <0.05). Patient satisfaction was comparable in the two groups.
conclusionsA combination of ketamine, magnesium, and clonidine could be more effective than opioid-based analgesia in reducing postoperative pain and lowering PONV occurrence after quadrantectomy for breast cancer.
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