The changing role of non-opioid analgesic techniques in the management of postoperative pain

Anesth Analg. 2005 Nov;101(5 Suppl):S5-22. doi: 10.1213/01.ane.0000177099.28914.a7.


Given the expanding role of ambulatory surgery and the need to facilitate an earlier hospital discharge, improving postoperative pain control has become an increasingly important issue for all anesthesiologists. As a result of the shift from inpatient to outpatient surgery, the use of IV patient-controlled analgesia and continuous epidural infusions has steadily declined. To manage the pain associated with increasingly complex surgical procedures on an ambulatory or short-stay basis, anesthesiologists and surgeons should prescribe multimodal analgesic regimens that use non-opioid analgesics (e.g., local anesthetics, nonsteroidal antiinflammatory drugs, cyclooxygenase inhibitors, acetaminophen, ketamine, alpha 2-agonists) to supplement opioid analgesics. The opioid-sparing effects of these compounds may lead to reduced nausea, vomiting, constipation, urinary retention, respiratory depression and sedation. Therefore, use of non-opioid analgesic techniques can lead to an improved quality of recovery for surgical patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Ambulatory Surgical Procedures
  • Analgesics, Non-Narcotic / therapeutic use*
  • Analgesics, Opioid / adverse effects
  • Drug Therapy, Combination
  • Humans
  • Pain, Postoperative / prevention & control*
  • Postoperative Nausea and Vomiting / prevention & control


  • Analgesics, Non-Narcotic
  • Analgesics, Opioid