Multimodal Opioid Sparing

Effective postoperative pain relief in cardiac surgery is essential to prevent both immediate and long-term complications from unmanaged pain. Acute pain is typically of moderate to severe intensity, most notably during the first 48 h. Although opioids are effective, relatively inexpensive, and available in various dosage forms, their common adverse effects, including sedation, respiratory depression, and ileus, can delay and complicate postoperative recovery. Anesthesiologists frequently use multimodal strategies to improve postoperative pain management and decrease opioid needs, incorporating agents such as NSAIDs, acetaminophen, ketamine, alpha-2 agonists, glucocorticoids, gabapentinoids, and fascial plane blocks. The Enhanced Recovery After Surgery (ERAS) Cardiac Society strongly recommends incorporating a multimodal, opioid-sparing strategy.