This course explores how to move beyond opioid-centric anesthesia by first unpacking the perioperative complications of opioids—respiratory depression, ileus, PONV, delirium, and long-term misuse risk—then walking through evidence-based non-opioid options including dexmedetomidine, acetaminophen, ketorolac, ketamine, lidocaine, gabapentinoids, magnesium, and regional techniques. You’ll see how to integrate these agents into multimodal analgesia and Enhanced Recovery Pathways to blunt surgical stress, improve functional recovery, and dramatically reduce (or even eliminate) perioperative opioid use while maintaining high-quality pain control.