Opioid-Sparing and Opioid-Free Anaesthesia: A Practical Implementation Review

This narrative review consolidates mechanisms, dosing, and monitoring for multimodal opioid-minimization strategies that pain and perioperative pharmacists can operationalize into institutional protocols.

📅 Journal publication: May 20, 2026 · Last updated: Oct 6, 2026

opioid-free anaesthesiaopioid-sparing anaesthesiadexmedetomidineketaminelidocaineacetaminophenketorolacNSAIDsalpha-2 agonistsNMDA antagonistsmultimodal analgesiaPONVperioperativeERASnarrative reviewpain management Perioperative / Anesthesia

Also in Pain Management

Background Information

Opioid-free anaesthesia speeds recovery and slashes opioid use.

Opioid-sparing and opioid-free anaesthesia techniques reduce opioid-related side effects and improve recovery outcomes. OSA and OFA reduce postoperative nausea and vomiting, expedite bowel function return, and lower opioid needs. These techniques require multidisciplinary coordination and tailored protocols for effective perioperative pain management. Review provides practical guidance. Opioid-sparing anaesthesia enhances recovery and minimizes opioid complications.

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Authors: Zhang Q, Ma Y, Liu J, Liu H

Citation: Zhang Q, Ma Y, Liu J, et al. Opioid-Sparing and Opioid-Free Anaesthesia: A Review of Clinical Evidence and Implementation Considerations. British journal of hospital medicine (London, England : 2005). 2026;87(5):54057. doi:10.31083/BJHM54057

Article Links: PubMed · Journal / DOI

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

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