Regional and centroneuraxial anesthesia can facilitate many procedures with minimal to no use of perioperative opioids, incorporating catheters for continuous post-operative analgesia. Techniques like paravertebral, pectoral nerve blocks, and local wound infiltration, especially in lower limb joint replacement surgeries, offer effective pain management without motor blockade. Epidural catheters are particularly effective in reducing opioids and improving early recovery outcomes in ERAS pathways, especially in open abdominal surgeries. Transversus abdominis plane (TAP) blocks, rectus sheath, quadratus lumborum, and erector spinae plane (ESP) blocks are increasingly utilized for abdominal and thoracic surgeries to enhance analgesia and reduce opioid requirements and thereby mitigating opioid-related adverse effects such as nausea, vomiting, ileus, and delirium.
Regional anesthesia is also advantageous for opioid-tolerant patients, often resulting in better-managed postoperative pain. Offering regional anesthesia/analgesia to these patients can significantly contribute to opioid reduction in the perioperative setting. The diverse array of regional techniques available allows for tailored pain management approaches across various surgical procedures, positioning anesthesiologists to make a meaningful impact on perioperative opioid reduction.
