Zhiwei Guo,1 Zhonggui Shan,2 Feifei Wang2 

1Department of Anesthesiology, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People’s Republic of China; 2Department of Cardiac Surgery, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People’s Republic of China

Correspondence: Feifei Wang, Department of cardiac surgery, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China, No. 55, Zhenhai Road, Siming, Xiamen, Fujian, 361000, People’s Republic of China, Email f340082558@outlook.com Zhonggui Shan, Department of cardiac surgery, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China, No. 55, Zhenhai Road, Siming, Xiamen, Fujian, 361000, People’s Republic of China, Email szgdoctor@126.com

Purpose: Opioid-free anesthesia (OFA), as a potential anesthetic strategy, can provide better clinical outcomes for surgical patients while avoiding opioid-related adverse side effects. However, the current knowledge framework and research progress in OFA have not yet been systematically reviewed or comprehensively analyzed. This study aims to employ bibliometric methods to thoroughly explore research trends, hotspots, and developmental directions in this field.
Methods: This study retrieved opioid-free anesthesia-related literature published between 1980 and 2024 from the Web of Science Core Collection database. Through systematic analysis of publications, countries, institutions, authors, journals, references, and keywords, combined with bibliometric visualization using software such as Citespace, VOSviewer, and Bibliometrix, this study comprehensively reveals the research status and developmental trends in this field.
Results: OFA research demonstrates a significant growth trend, with a sharp increase in publications over the past decade, reaching 2,219 citations in 2024 alone. The United States leads globally with 291 publications (7,896 citations) yet exhibits low international collaboration network density (0.008). Research hotspots evolve into three phases: early-stage focus on basic anesthetic protocols, mid-stage shift toward perioperative management optimization, and recent emphasis on clinical outcome improvement. Keyword analysis identified four core themes: anesthetic agents and protocols, perioperative management, and analgesic strategy optimization.
Conclusion: OFA research is in a phase of rapid development but requires enhanced international collaboration and clinical translation. Future efforts should focus on developing personalized OFA protocols, investigating long-term outcomes, and establishing multicenter research networks to provide higher-quality evidence for clinical practice.

Keywords: opioid-free anesthesia, pain, opioid, bibliometrics