Uso racional de opioides en anestesia para el manejo del dolor postoperatorio

Opioids are essential for postoperative pain control, although excessive prescribing is associated with adverse effects, persistent use and dependence. The study therefore aimed to analyse the rational use of opioids in anaesthesia for postoperative pain management, considering multimodal analgesia strategies with non-opioid drugs that improve patient safety and analgesic efficacy. A descriptive and analytical narrative review was conducted in PubMed/MEDLINE, SciELO, Epistemonikos and LILACS. Ketamine, intravenous lidocaine, paracetamol, non-steroidal anti-inflammatory drugs, metamizole and magnesium sulphate reduced opioid consumption, whereas prolonged use was associated with tolerance, opioid-induced hyperalgesia and endocrinopathy. It was concluded that rational use requires individualised multimodal analgesia, the lowest effective dose and follow-up.