Opioid-Sparing and Regional Strategies for Outpatient Postoperative Analgesia: Scoping Review with ☸️SAIMSARA

Name: SAIMSARA Evidence Object pain::OUTPATIENT_POSTOPERATIVE_ANALGESIA_PM
Creator: SAIMSARA
License: https://saimsara.com/license/

SAIMSARA

doi:10.62487/saimsara1b777a94

SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Opioid-Sparing and Regional Strategies for Outpatient Postoperative Analgesia: Scoping Review with ☸️SAIMSARA

Pain Medicine

Issue 6, Volume 1, 2026

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DOI: 10.62487/saimsara1b777a94

Editorial note

• Last update: 2026-06-13 09:50:51

What is this paper about

Outpatient postoperative pain can often be controlled with far fewer opioids—or none at all—when multimodal analgesia, regional anesthesia, and procedure-specific prescribing are used together. The full review shows which strategies most consistently reduce opioid exposure without sacrificing pain control, where evidence remains weak, and how safer outpatient analgesia pathways can be implemented in practice.

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Abstract: To systematically map the breadth and nature of evidence on interventions for outpatient postoperative analgesia, synthesizing findings across surgical disciplines to identify effective opioid-sparing and opioid-free strategies, characterize prescription and consumption patterns, and highlight key themes for clinical practice and future research. The review uses 141 references and builds its evidence map from 529 original studies with 419131 total participants/sample observations (topic-deduplicated ΣN). This scoping review indicates that a multimodal, opioid-sparing approach to outpatient postoperative analgesia is broadly feasible and effective across diverse surgical specialties, with structured education, non-opioid bundles, and regional anesthesia consistently associated with reduced opioid use without compromising pain control. Standardized pain care bundles were associated with substantial reductions in prescribing, for example from a median of 100 to 50 mg OME after breast surgery, while extended-release local anesthetic supported opioid-free recovery in 95% of herniorrhaphy patients. The evidence also highlights a recurrent mismatch between opioids prescribed and consumed, suggesting overprescription is a modifiable harm amenable to procedure-specific prescribing limits. For clinicians, these signals support adopting multimodal, regional-anesthesia-inclusive pathways as a default standard for ambulatory surgery. Because most evidence rests on heterogeneous, procedure-specific studies without formal appraisal, future pragmatic head-to-head trials comparing opioid-free bundles with standardized outcomes are needed to define the most effective regimens for individual procedures.
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Keywords: outpatient surgery; multimodal analgesia; opioid-sparing analgesia; regional anesthesia; nerve block; nonopioid analgesics; postoperative pain management; ambulatory anesthesia; analgesic consumption; patient satisfaction

Review Stats

Final search date and database lock: 2026-05-31 20:47:28 CEST
Plan: Pro (expanded craft tokens; source: PubMed)
Source: PubMed
Total Abstracts/Papers: 755
Downloaded Abstracts/Papers: 755
Included original and non-original Abstracts/Papers (all): 652
Included original Abstracts/Papers (Vote counting by direction of effect): 529
Reference Index (links used in paper): 141
Total participants/sample observations (topic deduplicated ΣN): 419131

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Reference Index (141)

[1] Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. — https://doi.org/10.1016/j.jpain.2015.12.008
[2] Preoperative anxiety and implications on postoperative recovery: what can we do to change our history. — https://doi.org/10.23736/s0375-9393.18.12520-x
[3] Pain management in surgical disciplines. — https://doi.org/10.48095/ccrvch2024478
[4] Postoperative Pain Management in Dermatologic Surgery: A Systematic Review. — https://doi.org/10.1016/j.det.2019.03.004
[5] Prospective Randomized Trial Comparing Opioids versus Nonsteroidal Antiinflammatory Drugs for Postoperative Analgesia in Outpatient Rhinoplasty. — https://doi.org/10.1097/prs.0000000000007427
[6] [Unicondylar knee arthroplasty-trigger for outpatient arthroplasty]. — https://doi.org/10.1007/s00132-024-04485-8
[7] Efficacy of PECS block in addition to multimodal analgesia for postoperative pain management in patients undergoing outpatient elective breast surgery: A retrospective study. — https://doi.org/10.3389/fmed.2022.975080
[8] Continuous peripheral nerve blocks in clinical practice. — https://doi.org/10.1097/aco.0b013e32830c66c2

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