Effectiveness of Multimodal Analgesia versus Opioid-Based Analgesia in Postoperative Pain Management

Background: Postoperative pain remains a major determinant of early recovery, patient comfort, mobilization, and hospital resource use. Opioids provide effective analgesia but are limited by nausea, vomiting, sedation, pruritus, respiratory depression, and delayed functional recovery. Multimodal analgesia combines agents and techniques acting through different pain pathways to improve analgesia while reducing opioid exposure. The objective is to compare the effectiveness and safety of multimodal analgesia with opioid-based analgesia in postoperative pain management. Material and Methods: This prospective comparative study included 60 postoperative patients at Kamineni Institute of Medical Sciences, Narketpally, Telangana, India, from August 2024 to July 2025. Patients were divided into Group M receiving multimodal analgesia and Group O receiving opioid-based analgesia, with 30 patients in each group. Pain was assessed using the visual analogue scale at 2, 6, 12, and 24 hours after surgery. Rescue analgesic requirement, time to first rescue analgesia, opioid consumption, adverse effects, patient satisfaction, and hospital stay were recorded. Results: Baseline demographic and clinical variables were comparable between the groups. Group M had significantly lower mean VAS scores at 2, 6, 12, and 24 hours. Rescue analgesia was required in 26.7% of patients in Group M and 60.0% in Group O. Time to first rescue analgesia was longer in Group M, and total opioid consumption was lower. Nausea, vomiting, sedation, and pruritus were more frequent in Group O. Patient satisfaction was higher and hospital stay was shorter in Group M. Conclusion: Multimodal analgesia provided superior postoperative pain control with reduced opioid requirement, fewer opioid-related adverse effects, higher patient satisfaction, and shorter hospital stay compared with opioid-based analgesia.

Keywords: Multimodal analgesia; opioid analgesia; postoperative pain; visual analogue scale; rescue analgesia; opioid-sparing analgesia.