Trial reportRegional anesthesia and pain medicine2026
Impact of opioid-free general anesthesia with locoregional blocks during breast cancer surgery on systemic inflammatory response: results from a randomized controlled trial.
Trial report in Regional anesthesia and pain medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04172220 (Variation of the Neutrophil To Lymphocyte Ratio During Opioid-Free General Anesthesia Associated With Thoracic Wall Blocks Vs General Anesthesia, in Breast Cancer Quadrantectomy), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Variation of the Neutrophil To Lymphocyte Ratio During Opioid-Free General Anesthesia Associated With Thoracic Wall Blocks Vs General Anesthesia, in Breast Cancer Quadrantectomy: a Randomized Controlled Trial
Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor breast cancer patients with localized disease, surgery remains a cornerstone of treatment. Anesthesia during surgery is essential for pain management and influences patient recovery. Opioid-free general anesthesia with locoregional blocks (OfGA), as an alternative to traditional opioid-based general anesthesia (GA), may improve patient outcomes.
methodsWe set up a randomized trial to compare the impact of different anesthetic approaches on post surgical inflammation in breast cancer patients undergoing quadrantectomy. Patients were randomized to receive GA (n=34) or OfGA (n=34). Blood samples were collected pre-surgery and 1 hour and 24 hours post-surgery. As primary endpoint, neutrophil-to-lymphocyte ratio (NLR) was calculated. As secondary endpoints we collected data on side effects, pain management, and circulating inflammatory cytokines.
resultsPatients of the GA arm displayed significantly increased NLR, both at 1 (median change +0.13, IQR 0.01 to 0.62, p<0.0001) and 24 (median change +0.64, IQR 0.28 to 1.03, p<0.0001) hours post-surgery, compared with baseline. On the contrary, the OfGA arm displayed stable or minimally increased NLR (median change -0.08, IQR -0.21 to 0.17, p=ns, at 1 hour; +0.11, IQR -0.11 to 0.36, p=ns, at 24 hours post-surgery). Circulating inflammatory cytokines aligned with NLR data, showing significant increases in key inflammatory factors in samples from the GA arm compared with the OfGA arm. Pain management was similar in both arms, but OfGA was better tolerated and elicited fewer side effects.
conclusionsIn breast cancer surgery, opioid-free general anesthesia combined with locoregional blocks was associated with a reduced postoperative inflammatory response compared with conventional opioid-based general anesthesia, without compromising pain control. Further research is needed to determine whether these biological effects translate into meaningful clinical outcomes. TRIAL REGISTRATION NUMBER: NCT04172220.
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