We thank Forget et al.1 and Ingrande and Drummond2 for their interest in our review on perioperative opioid administration.3 Forget et al. contend that we did not distinguish between opioid-free anesthesia and opioid-free analgesia and ignored published studies and a meta-analysis.4 On the contrary, we explicitly distinguish between these two phases of care and even abbreviate them, so as to clarify our position throughout. Unfortunately, the definition of opioid-free anesthesia in literature seems to be loosely applied and consequentially misinterpreted. Whether opioid-free anesthesia means total abstinence or relative lack of intraoperative opioids is unclear. We discuss this as an important limitation of the review and meta-analysis by Frauenknecht et al.,4 in which included studies used opioids during the intraoperative period, thereby resulting in a potentially inappropriate conclusion.5 Furthermore, our statement that total avoidance of perioperative opioids has no influence on the...
Opioid-free Anesthesia: Reply
(Accepted for publication July 6, 2021. Published online first on August 13, 2021.)
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Harsha Shanthanna, Karim S. Ladha, Henrik Kehlet, Girish P. Joshi; Opioid-free Anesthesia: Reply. Anesthesiology 2021; 135:758–759 doi: https://doi.org/10.1097/ALN.0000000000003907
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