{
  "abstract": "Background/Objectives: Women undergoing breast or gynecologic surgery face high postoperative nausea and vomiting (PONV) risk, which often prompts discontinuation of opioid patient-controlled analgesia (PCA). Since anticipated opioid use is an Apfel risk factor, we examined a postoperative opioid-free analgesic regimen using opiranserin, previously evaluated only as an adjunct. Methods: In this single-center retrospective cohort study, 150 women undergoing breast or minimally invasive gynecologic surgery received a multistep opiranserin infusion via a PCA pump without demand boluses (n = 77) or fentanyl demand bolus PCA (n = 73). The opiranserin infusion ended at 10 h; fentanyl PCA remained connected throughout. The primary outcome was resting numeric rating scale (NRS, 0–10) at 24 h, by which time the infusion had been complete for 14–15 h; secondary outcomes were post-anesthesia care unit (PACU) and 6 h NRS, PONV, and early discontinuation. Results: Resting NRS did not differ significantly during the infusion (PACU p = 0.965; 6 h p = 0.675), with a larger difference at 24 h. The adjusted 24 h difference was 0.58 points higher with opiranserin (95% CI, 0.04 to 1.12; p = 0.036) by covariance analysis on pre-treatment covariates and 0.55 (0.02 to 1.09) by inverse-probability-of-treatment weighting; the point estimates were below the minimal clinically important difference of 1 point, but the confidence intervals do not exclude a clinically relevant increase in pain, and the estimate was nonsignificant after adjusting for non-opioid adjuncts (p = 0.177). Moderate or severe pain at 24 h was more frequent with opiranserin (19.5% vs. 8.2%; adjusted odds ratio, 3.76; 95% CI, 1.34 to 11.82). PONV (9.1% vs. 11.0%), rescue analgesia (26.0% vs. 17.8%), and early discontinuation (10.4% vs. 9.6%) were similar. Rescue opioids were available to both groups but used by one fentanyl-group patient and by none receiving opiranserin. Conclusions: The regimen eliminated postoperative opioid exposure, with resting pain scores that differed by less than 1 NRS point on average, although a clinically relevant increase cannot be excluded. With coverage fixed at 10 h, the 24 h difference cannot be separated into a shortfall of the agent and a shortfall of coverage. The anticipated PONV reduction was not observed, possibly in the context of low event rates and routine antiemetic prophylaxis.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology and Pain Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea",
    "Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea",
    "Department of Obstetrics and Gynecology, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea",
    "Department of Obstetrics and Gynecology, Chungnam National University Hospital, 33 Munhwa-ro, Jung-gu, Daejeon 35015, Republic of Korea",
    "Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea",
    "Biomedical Research Institute, Chungnam National University Hospital, Daejeon 35015, Republic of Korea"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Yeojung Kim"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Mia Park"
    },
    {
      "affs": [
        0
      ],
      "name": "Sungho Choi"
    },
    {
      "affs": [
        0
      ],
      "name": "Juyeon Kim"
    },
    {
      "affs": [
        4
      ],
      "name": "Jinwoo Kim"
    },
    {
      "affs": [
        5
      ],
      "name": "Yeonsu Kim"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Seounghun Lee"
    },
    {
      "affs": [
        1,
        4
      ],
      "name": "Chan Noh"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jiho Park",
      "orcid": "0000-0001-5233-430X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2c46jreptr1jr.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208062",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706320/?tool=EBI",
  "id": "2c46jreptr1jr",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8062",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Anesthesia and Pain Management"
    ]
  ],
  "openalex": "W7222914197",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706320/pdf/?tool=EBI",
  "pmcid": "PMC13706320",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/2c46jreptr1jr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15208062",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8062"
    },
    {
      "first_seen": "2026-10-30T12:21:31Z",
      "native_id": "PMC:PMC13706320",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13706320"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Anesthesia and Pain Management",
      "subfield": "surgery"
    }
  ],
  "title": "Postoperative Opioid-Free Multistep Opiranserin Infusion Versus Fentanyl Patient-Controlled Analgesia After Breast or Minimally Invasive Gynecologic Surgery: A Retrospective Cohort Study",
  "title_text": "Postoperative Opioid-Free Multistep Opiranserin Infusion Versus Fentanyl Patient-Controlled Analgesia After Breast or Minimally Invasive Gynecologic Surgery: A Retrospective Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:31Z",
  "url": "https://research.draconitic.com/paper/2c46jreptr1jr",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}