Effective perioperative pain management has shifted from an opioid-centric, reactive model to a proactive, patient-centered approach focused on Multimodal Analgesia (MMA) and preventive care. The primary goal is to provide adequate pain relief while minimizing opioid consumption, accelerating functional recovery, and preventing the transition of acute pain into chronic post-surgical pain (CPSP).

Multimodal and Preventive Analgesia MMA involves combining different classes of medications—such as acetaminophen, NSAIDs, gabapentinoids, NMDA antagonists (e.g., ketamine), and alpha-2 agonists (e.g., dexmedetomidine)—with local and regional anesthesia. This synergistic approach significantly reduces opioid requirements, thereby lowering the risk of adverse effects like respiratory depression, nausea, and addiction. Additionally, preventive analges ...