OPIOID-FREE ANESTHESIA: CLINICAL EVIDENCE AND IMPLICATIONS FOR POSTOPERATIVE PAIN CONTROL
DOI:
https://doi.org/10.36557/2674-9432.2026v5n1p2982-2994Palavras-chave:
Opioid-free anesthesia; postoperative pain; multimodal analgesia.Resumo
Postoperative pain remains a significant challenge in perioperative care, as inadequate pain control is associated with poorer clinical outcomes, delayed functional recovery, and prolonged hospital stay. Traditionally, opioids have played a central role in surgical analgesic strategies; however, their adverse effects and the context of the global opioid crisis have driven the search for alternative analgesic approaches. In this scenario, opioid-free anesthesia (OFA) has emerged as a strategy based on multimodal analgesia, employing different pharmacological agents and anesthetic techniques to modulate nociception without the use of opioids during the intraoperative period. The present study aimed to analyze, through a narrative review of the literature, the clinical evidence related to opioid-free anesthesia and its implications for postoperative pain control. To this end, a literature search was conducted in the PubMed/MEDLINE, ScienceDirect, SpringerLink, and Frontiers databases, considering publications between 2020 and 2026. The analyzed studies indicate that OFA protocols may reduce the incidence of postoperative nausea and vomiting and decrease opioid consumption in the postoperative period in certain clinical contexts. However, the results remain heterogeneous regarding their superiority over conventional opioid-based anesthetic strategies, particularly with respect to pain intensity during the first 24 hours after surgery. It can be concluded that opioid-free anesthesia represents a promising strategy in the context of perioperative analgesia and should be interpreted as part of a broader multimodal approach, whose effectiveness depends on appropriate patient selection, the type of surgical procedure, and the pharmacological protocol employed.
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Copyright (c) 2026 Rafael Ignacio, Rodolfo de Oliveira Medeiros, Cristiano Machado Galhardi, Paula Masi, Sophia Evaristo Coércio, Luan Tavares Amadeu, João Felipi Fernandes Riguette, José Antonio Pizzolato Neto, João Victor Laiola De Oliveira Barbosa, Letícia Cher Messias Pavoni, Manuela Mello Guerra, Pedro Henrique Lima Domingues
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