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Volume 20, Issue 2
  • ISSN: 2772-4328
  • E-ISSN: 2772-4336
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Abstract

The opioid crisis has profoundly changed the interest in using nonopioid analgesics. This review identified nonopioid drugs receiving the most interest in the treatment of postoperative pain. Publication-based interest, which reflects the authors’ choices of subjects for academic articles, was used to show the shifts in their interest. The authors’ choices of a particular drug for an article’s subject were regarded as reflective of the collective opinion of experts most knowledgeable on the subject. The frequency with which a drug was the topic of an article was measured with the use of specific bibliometric indices. They were employed to select nonopioid drugs for this review. These included acetaminophen, dexmedetomidine, dexamethasone, ketamine, gabapentin, ibuprofen, ketorolac, diclofenac, magnesium sulfate, clonidine, intravenous lidocaine, and meloxicam (in order of most to least bibliometric interest). Individual reviews on these agents described how the bibliometric indices characterized a drug. They also addressed the question of whether a nonopioid analgesic produced a marked opioid-sparing effect. Information relative to this question was presented the results of meta-analyses with emphasis on the possible reduction of opioid-related side effects. Overall, nonopioid drugs demonstrating the largest popularity among authors and continuous interest growth in 2018-2022 include acetaminophen, dexmedetomidine, dexamethasone, and ibuprofen. The relevant meta-analyses show that nonopioids, administered as components of multimodal analgesia, provided the opioid-sparing effect; they also show that the most common change in the opioid-related side effects was a lower incidence of postoperative nausea and vomiting.

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© 2025 The Author(s). Published by Bentham Science Publishers. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2024-10-01
2025-04-19

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References

  1. KharaschE.D. AvramM.J. ClarkJ.D. Rational perioperative opioid management in the era of the opioid crisis.Anesthesiology2020133494294310.1097/ALN.0000000000003497 32773694
     [Google Scholar]
  2. OkieS. A flood of opioids, a rising tide of deaths.N. Engl. J. Med.20103632119811985
     [Google Scholar]
  3. KehletH. DahlJ.B. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment.Anesth. Analg.19937751048105610.1213/00000539‑199311000‑00030 8105724
     [Google Scholar]
  4. JoshiG.P. Rational multimodal analgesia for perioperative pain management.Curr. Pain Headache Rep.202327822723710.1007/s11916‑023‑01137‑y 37405552
     [Google Scholar]
  5. KissinI. Can a bibliometric indicator predict the success of an analgesic?Scientometrics201186378579510.1007/s11192‑010‑0320‑7
     [Google Scholar]
  6. KissinI. BradleyE.L.Jr Top journals selectivity index and “me-too” drugs.Scientometrics201291113114210.1007/s11192‑011‑0556‑x
     [Google Scholar]
  7. VlassakovK.V. KissinI. Drug Des Devel Ther. 2014;8:2463-2473.Published20132014910.2147/DDDT.S73862 25525336
     [Google Scholar]
  8. KissinI. What can big data on academic interest reveal about a drug? Reflections in three major us databases.Trends Pharmacol. Sci.201839324825710.1016/j.tips.2017.12.005 29358009
     [Google Scholar]
  9. KumarK. KirkseyM.A. DuongS. WuC.L. A review of opioid-sparing modalities in perioperative pain management: Methods to decrease opioid use postoperatively.Anesth. Analg.201712551749176010.1213/ANE.0000000000002497 29049119
     [Google Scholar]
  10. FioreJ.F. OilekG. El-KefraouiC. Preventing opioid prescription after major surgery: A scoping review of opioid-free analgesia.Br. J. Anaesth.2019123562763610.1016/j.bja.2019.08.014
     [Google Scholar]
  11. ShanthannaH. LadhaK.S. KehletH. JoshiG.P. Perioperative opioid administration.Anesthesiology2021134464565910.1097/ALN.0000000000003572 32991672
     [Google Scholar]
  12. HurleyR.W. ElkassabanyN.M. WuC.L. Acute postoperative pain. In: Miller’s Anesthesia.9th edPhiladelphiaElsevier202026142638
     [Google Scholar]
  13. PaulozziL.J. BudnitzD.S. XiY. Increasing deaths from opioid analgesics in the United States.Pharmacoepidemiol. Drug Saf.200615961862710.1002/pds.1276 16862602
     [Google Scholar]
  14. GrosserT. SmythE. FitzgeraldG.A. Anti-inflammatory, antipyretic, and analgesic agents. In: Goodman and gilman’s the pharmacological basis of therapeutics.12th edNew YorkMcGrow Hill2011
     [Google Scholar]
  15. EliaN. LysakowskiC. TramèrM.R. Does multimodal analgesia with acetaminophen, nonsteroidal anti-inflammatory drugs, or selective cyclooxygenase-2 inhibitors and patient-controlled analgesia morphine offer advantages over morphine alone?Anesthesiology200510361296130410.1097/00000542‑200512000‑00025 16306743
     [Google Scholar]
  16. DolemanB. ReadD. LundJ.N. WilliamsJ.P. Preventive acetaminophen reduces postoperative opioid consumption, vomiting, and pain scores after surgery.Reg. Anesth. Pain Med.201540670671210.1097/AAP.0000000000000311 26469366
     [Google Scholar]
  17. MartinezV. BeloeilH. MarretE. FletcherD. RavaudP. TrinquartL. Non-opioid analgesics in adults after major surgery: Systematic review with network meta-analysis of randomized trials.Br. J. Anaesth.20171181223110.1093/bja/aew391 28039239
     [Google Scholar]
  18. GuoH. WangC. HeY. A meta-analysis evaluates the efficacy of intravenous acetaminophen for pain management in knee or hip arthroplasty.J. Orthop. Sci.201823579380010.1016/j.jos.2018.04.008 29910098
     [Google Scholar]
  19. FillinghamY.A. HannonC.P. ErensG.A. The efficacy and safety of acetaminophen in total joint arthroplasty: Systematic review and direct meta-analysis.J. Arthroplasty202035102715272910.1016/j.arth.2020.05.037 32563592
     [Google Scholar]
  20. BaeS. AlboogA. EsquivelK.S. AbbasiA. ZhouJ. ChuiJ. Efficacy of perioperative pharmacological and regional pain interventions in adult spine surgery: A network meta-analysis and systematic review of randomised controlled trials.Br. J. Anaesth.202212819811710.1016/j.bja.2021.08.034 34774296
     [Google Scholar]
  21. KamibayashiT. MazeM. WeiskopfR.B. WeiskopfR.B. ToddM.M. Clinical uses of alpha2 -adrenergic agonists.Anesthesiology20009351345134910.1097/00000542‑200011000‑00030 11046225
     [Google Scholar]
  22. WeerinkM.A.S. StruysM.M.R.F. HannivoortL.N. BarendsC.R.M. AbsalomA.R. ColinP. Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine.Clin. Pharmacokinet.201756889391310.1007/s40262‑017‑0507‑7 28105598
     [Google Scholar]
  23. EsmaogluA. YegenogluF. AkinA. TurkC.Y. Dexmedetomidine added to levobupivacaine prolongs axillary brachial plexus block.Anesth. Analg.201011161548155110.1213/ANE.0b013e3181fa3095 20889939
     [Google Scholar]
  24. VorobeichikL. BrullR. AbdallahF.W. Evidence basis for using perineural dexmedetomidine to enhance the quality of brachial plexus nerve blocks: A systematic review and meta-analysis of randomized controlled trials.Br. J. Anaesth.2017118216718110.1093/bja/aew411 28100520
     [Google Scholar]
  25. BrummettC.M. HongE.K. JandaA.M. AmodeoF.S. LydicR. Perineural dexmedetomidine added to ropivacaine for sciatic nerve block in rats prolongs the duration of analgesia by blocking the hyperpolarization-activated cation current.Anesthesiology2011115483684310.1097/ALN.0b013e318221fcc9 21666435
     [Google Scholar]
  26. BlaudszunG. LysakowskiC. EliaN. TramèrM.R. Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: Systematic review and meta-analysis of randomized controlled trials.Anesthesiology201211661312132210.1097/ALN.0b013e31825681cb 22546966
     [Google Scholar]
  27. ZhaoW. LiJ. WangN. Effect of dexmedetomidine on postoperative nausea and vomiting in patients under general anaesthesia: An updated meta-analysis of randomised controlled trials.BMJ Open2023138e06710210.1136/bmjopen‑2022‑067102 37527891
     [Google Scholar]
  28. WatchaM.F. WhiteP.F. Postoperative nausea and vomiting. Its etiology, treatment, and prevention.Anesthesiology199277116218410.1097/00000542‑199207000‑00023 1609990
     [Google Scholar]
  29. TuranA. SesslerD.I. Steroids to ameliorate postoperative pain.Anesthesiology2011115345745910.1097/ALN.0b013e31822a2871 21792052
     [Google Scholar]
  30. GanT.J. MeyerT.A. ApfelC.C. Society for ambulatory anesthesia guidelines for the management of postoperative nausea and vomiting.Anesth. Analg.200710561615162810.1213/01.ane.0000295230.55439.f4 18042859
     [Google Scholar]
  31. AlbrechtE. KernC. KirkhamK.R. A systematic review and meta‐analysis of perineural dexamethasone for peripheral nerve blocks.Anaesthesia2015701718310.1111/anae.12823 25123271
     [Google Scholar]
  32. De OliveiraG.S.Jr AlmeidaM.D. BenzonH.T. McCarthyR.J. Perioperative single dose systemic dexamethasone for postoperative pain: A meta-analysis of randomized controlled trials.Anesthesiology2011115357558810.1097/ALN.0b013e31822a24c2 21799397
     [Google Scholar]
  33. WaldronN.H. JonesC.A. GanT.J. AllenT.K. HabibA.S. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: Systematic review and meta-analysis.Br. J. Anaesth.2013110219120010.1093/bja/aes431 23220857
     [Google Scholar]
  34. HannonC.P. FillinghamY.A. MasonJ.B. The efficacy and safety of corticosteroids in total joint arthroplasty: A direct meta-analysis.J. Arthroplasty2022371018981905.e710.1016/j.arth.2022.03.084 36162922
     [Google Scholar]
  35. OrmsethC.H. LaHueS.C. OldhamM.A. JosephsonS.A. WhitakerE. DouglasV.C. Predisposing and precipitating factors associated with delirium.JAMA Netw. Open202361e224995010.1001/jamanetworkopen.2022.49950 36607634
     [Google Scholar]
  36. HuizengaN.A.T.M. KoperJ.W. de LangeP. Interperson variability but intraperson stability of baseline plasma cortisol concentrations, and its relation to feedback sensitivity of the hypothalamo-pituitary-adrenal axis to a low dose of dexamethasone in elderly individuals.J. Clin. Endocrinol. Metab.1998831475410.1210/jcem.83.1.4498 9435415
     [Google Scholar]
  37. SchmidR.L. SandlerA.N. KatzJ. Use and efficacy of low-dose ketamine in the management of acute postoperative pain: A review of current techniques and outcomes.Pain199982211112510.1016/S0304‑3959(99)00044‑5 10467917
     [Google Scholar]
  38. BellR.F. KalsoE.A. Ketamine for pain management.Pain Rep.201835e67410.1097/PR9.0000000000000674 30534625
     [Google Scholar]
  39. LaskowskiK. StirlingA. McKayW.P. LimH.J. A systematic review of intravenous ketamine for postoperative analgesia.Can. J. Anaesth.2011581091192310.1007/s12630‑011‑9560‑0 21773855
     [Google Scholar]
  40. WangL. JohnstonB. KaushalA. ChengD. ZhuF. MartinJ. Ketamine added to morphine or hydromorphone patient-controlled analgesia for acute postoperative pain in adults: A systematic review and meta-analysis of randomized trials.Can. J. Anaesth.201663331132510.1007/s12630‑015‑0551‑4 26659198
     [Google Scholar]
  41. XuB. WangY. ZengC. Analgesic efficacy and safety of ketamine after total knee or hip arthroplasty: a meta-analysis of randomised placebo-controlled studies.BMJ Open201999e028337
     [Google Scholar]
  42. HurleyR.W. CohenS.P. WilliamsK.A. RowlingsonA.J. WuC.L. The analgesic effects of perioperative gabapentin on postoperative pain: A meta-analysis.Reg. Anesth. Pain Med.200631323724710.1097/00115550‑200605000‑00011 16701190
     [Google Scholar]
  43. PengP.W.H. WijeysunderaD.N. LiC.C.F. Use of gabapentin for perioperative pain control -- A meta-analysis.Pain Res. Manag.2007122859210.1155/2007/840572 17505569
     [Google Scholar]
  44. VerretM. LauzierF. ZarychanskiR. Perioperative use of gabapentinoids for the management of postoperative acute pain.Anesthesiology2020133226527910.1097/ALN.0000000000003428 32667154
     [Google Scholar]
  45. XuanC. YanW. WangD. Efficacy of preemptive analgesia treatments for the management of postoperative pain: A network meta-analysis.Br. J. Anaesth.2022129694695810.1016/j.bja.2022.08.038 36404458
     [Google Scholar]
  46. ZhangJ. HoK.Y. WangY. Efficacy of pregabalin in acute postoperative pain: A meta-analysis.Br. J. Anaesth.2011106445446210.1093/bja/aer027 21357616
     [Google Scholar]
  47. TsaiS.H.L. HuC.W. El SammakS. Different gabapentin and pregabalin dosages for perioperative pain control in patients undergoing spine surgery.JAMA Netw. Open202368e232812110.1001/jamanetworkopen.2023.28121 37556139
     [Google Scholar]
  48. KimS.Y. LeeS. LeeY. KimH. KimK.M. Effect of single dose preoperative intravenous ibuprofen on postoperative pain and opioid consumption: A systematic review and meta-analysis.Korean J. Anesthesiol.202174540942110.4097/kja.21050 33611881
     [Google Scholar]
  49. De OliveiraG.S.Jr AgarwalD. BenzonH.T. Perioperative single dose ketorolac to prevent postoperative pain: A meta-analysis of randomized trials.Anesth. Analg.2012114242443310.1213/ANE.0b013e3182334d68 21965355
     [Google Scholar]
  50. de BaaijJ.H.F. HoenderopJ.G.J. BindelsR.J.M. Magnesium in man: Implications for health and disease.Physiol. Rev.201595114610.1152/physrev.00012.2014 25540137
     [Google Scholar]
  51. KirkseyM.A. HaskinsS.C. ChengJ. LiuS.S. Local anesthetic peripheral nerve block adjuvants for prolongation of analgesia: A systematic qualitative review.PLoS One2015109e013731210.1371/journal.pone.0137312 26355598
     [Google Scholar]
  52. De OliveiraG.S.Jr Castro-AlvesL.J. KhanJ.H. McCarthyR.J. Perioperative systemic magnesium to minimize postoperative pain: A meta-analysis of randomized controlled trials.Anesthesiology2013119117819010.1097/ALN.0b013e318297630d 23669270
     [Google Scholar]
  53. AlbrechtE. KirkhamK.R. LiuS.S. BrullR. Peri‐operative intravenous administration of magnesium sulphate and postoperative pain: A meta‐analysis.Anaesthesia2013681799010.1111/j.1365‑2044.2012.07335.x 23121612
     [Google Scholar]
  54. NgK.T. YapJ.L.L. IzhamI.N. TeohW.Y. KwokP.E. KohW.J. The effect of intravenous magnesium on postoperative morphine consumption in noncardiac surgery.Eur. J. Anaesthesiol.202037321222310.1097/EJA.0000000000001164 31977626
     [Google Scholar]
  55. HeybatiK. ZhouF. BaltazarM. Appraisal of postoperative outcomes of volatile and intravenous anesthetics: A network meta-analysis of patients undergoing cardiac surgery.J. Cardiothorac. Vasc. Anesth.202337112215222210.1053/j.jvca.2023.07.011 37573213
     [Google Scholar]
  56. SchubertA.K. SeneviratneV. StolzJ. The effect of adjuvants added to local anaesthetics for single-injection upper extremity peripheral regional anaesthesia.Eur. J. Anaesthesiol.202340967269010.1097/EJA.0000000000001860 37337656
     [Google Scholar]
  57. CorrellD.J. VlassakovK.V. KissinI. No evidence of real progress in treatment of acute pain, 1993-2012: Scientometric analysis.J. Pain Res.20147199210 24748816
     [Google Scholar]
  58. GanT.J. Poorly controlled postoperative pain: Prevalence, consequences, and prevention.J. Pain Res.2017102287229810.2147/JPR.S144066 29026331
     [Google Scholar]
  59. MillsE.J. ThorlundK. IoannidisJ.P.A. Demystifying trial networks and network meta-analysis.BMJ2013346f291410.1136/bmj.f2914 23674332
     [Google Scholar]
  60. IngrandeJ. DrammondJ.C. Opioid-free anesthesia.Comment Anesthesiology2021135475375510.1097/ALN.0000000000003909 34388825
     [Google Scholar]
  61. BongiovanniT. LancasterE. LedesmaY. Systematic review and meta–analysis of the association between non–steroidal anti–inflammatory drugs and operative bleeding in the perioperative period.J. Am. Coll. Surg.20212325765790e110.1016/j.jamcollsurg.2021.01.005 33515678
     [Google Scholar]
  62. KissinI. Patient-controlled-analgesia analgesimetry and its problems.Anesth. Analg.200910861945194910.1213/ane.0b013e3181a1a481 19448227
     [Google Scholar]
  63. AustinK.L. StapletonJ.V. MatherL.E. Relationship between blood meperidine concentrations and analgesic response: A preliminary report.Anesthesiology198053646046610.1097/00000542‑198012000‑00005 7457961
     [Google Scholar]
  64. KissinI. BrightC.A. BradleyE.L.Jr The effect of ketamine on opioid-induced acute tolerance: Can it explain reduction of opioid consumption with ketamine-opioid analgesic combinations?Anesth. Analg.20009161483148810.1097/00000539‑200012000‑00035 11094005
     [Google Scholar]
  65. BinghamA.E. FuR. HornJ.L. AbrahamsM.S. Continuous peripheral nerve block compared with single-injection peripheral nerve block: A systematic review and meta-analysis of randomized controlled trials.Reg. Anesth. Pain Med.201237658359410.1097/AAP.0b013e31826c351b 23080349
     [Google Scholar]
  66. BorgeatA. Single-shot interscalene block.Anesth. Analg.2015120599599610.1213/ANE.0000000000000660 25899266
     [Google Scholar]
  67. SinghN.P. MakkarJ.K. KuberanA. GuffeyR. UppalV. Efficacy of regional anesthesia techniques for postoperative analgesia in patients undergoing major oncologic breast surgeries: A systematic review and network meta-analysis of randomized controlled trials.Can. J. Anaesth.202269452754910.1007/s12630‑021‑02183‑z 35102494
     [Google Scholar]
  68. BarryG. SehmbiH. RetterS. BaileyJ.G. TablanteR. UppalV. Comparative efficacy and safety of non-neuraxial analgesic techniques for midline laparotomy: A systematic review and frequentist network meta-analysis of randomised controlled trials.Br. J. Anaesth.202313161053107110.1016/j.bja.2023.08.024 37770254
     [Google Scholar]
  69. KissinI. Scientometric assessment of drugs for chronic pain, 1979–2013: Rapid growth of publications, paucity of successful drugs.J. Pain Res.2014750551410.2147/JPR.S67479 25187736
     [Google Scholar]
/content/journals/crcep/10.2174/0127724328327509240919102209
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Nonopioid Drugs for Postoperative Pain: A Selection Governed by Choices of the Authors of Academic Articles
Curr Rev Clin Exper Pharm 20, 158 (2025); https://doi.org/10.2174/0127724328327509240919102209
/content/journals/crcep/10.2174/0127724328327509240919102209
/content/journals/crcep/10.2174/0127724328327509240919102209
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  • Article Type:     Review Article
Keyword(s): academic articles; Nonopioid; nonopioid analgesics; opioid crisis; postoperative pain

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