Opioid-free Anesthesia in Cardiac Surgery: The OFACAR Randomized Clinical Trial.
Pierre-Grégoire Guinot, Guillaume Besch, Lysiane Jonval et al.
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In 30 seconds
The OFACAR trial was a randomized, controlled, multicenter study involving 320 adults undergoing elective cardiac surgery. It compared opioid-free anesthesia (OFA) to opioid anesthesia. The primary outcome, a composite of postoperative complications, occurred in 75.4% of the OFA group versus 84.5% in the control group (risk ratio 0.90; P = 0.049), suggesting OFA may reduce complications.
Key findings
- 75.4% of patients in the OFA group experienced primary outcome events compared to 84.5% in the control group.
- OFA significantly reduced cardiovascular complications (64.2% vs 75.2%; P = 0.031).
- No deaths occurred in the OFA group, while six deaths were reported in the control group (P = 0.014).
- OFA was associated with fewer digestive complications (2.5% vs 11.2%; P = 0.007).
Why it matters
This study provides evidence that opioid-free anesthesia may lead to fewer postoperative complications in cardiac surgery, which is crucial for improving patient outcomes and reducing healthcare costs associated with complications.
What to keep in mind
The fragility index for the primary outcome was 1, indicating the need for further confirmation in larger trials.