Role of Multimodal Analgesia in Reducing Opioid Dependence in Postoperative Patients: A Retrospective Study at a Tertiary Care Centre

Abstract

Background: Postoperative pain remains one of the most common causes of prolonged opioid exposure following surgery. Although opioids provide effective analgesia, their use is associated with adverse effects including respiratory depression, postoperative nausea and vomiting, constipation, delayed mobilization, and the risk of persistent opioid dependence. Multimodal analgesia (MMA), which combines analgesics with different mechanisms of action, has emerged as an effective strategy to optimize pain control while minimizing opioid consumption. Objective: To evaluate the effectiveness of multimodal analgesia in reducing postoperative opioid requirements and improving clinical outcomes among surgical patients. Materials and Methods: A retrospective observational study was conducted at J P Nursing Home, BLW Road, Kakarmatta, Varanasi, over an eight-month period. Forty-five adult patients undergoing elective or emergency surgical procedures were included. Clinical records were reviewed for demographic characteristics, type of surgery, analgesic regimen, postoperative pain scores, opioid consumption during the first 72 postoperative hours, opioid-related adverse effects, mobilization time, and duration of hospital stay. Pain severity was assessed using the Numeric Rating Scale (NRS). Statistical analysis was performed using SPSS version 26. Continuous variables were compared using Student's t-test, while categorical variables were analyzed using the Chi-square or Fisher's exact test. A p-value <0.05 was considered statistically significant. Results: Among the 45 patients included, the mean age was 46.8 ± 13.4 years, with males comprising 57.8%. Patients receiving multimodal analgesia demonstrated significantly lower postoperative opioid consumption, lower pain scores at 24 and 48 hours, fewer opioid-related adverse effects, earlier ambulation, and shorter hospital stay compared with conventional opioid-based analgesia (p<0.05). Conclusion: Multimodal analgesia significantly reduces postoperative opioid requirements while providing superior pain control and enhanced postoperative recovery. Routine implementation of multimodal analgesic protocols may contribute to improved patient outcomes and reduced opioid dependence following surgery.