Abstract
It has been speculated that opioid-free anesthesia may provide adequate pain control while reducing postoperative opioid consumption; however, there is currently no evidence to support the speculation. In this issue of Anesthesiology, Beloeil et al. tested the hypothesis that opioid-free balanced anesthetic with dexmedetomidine would reduce postoperative opioid-related adverse events compared to balanced anesthesia with remifentanil. Also in this issue, Shanthanna et al. present a critical review of opioid-free versus opioid-sparing approaches. In an accompanying editorial, Kharasch and Clark review the evolution of opioid-free anesthesia and call for a balanced approach to use of opioids in moderation going forward. Cover Illustration: A. Johnson, Vivo Visuals.
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