Opioid-Free Patients Require Less Rescue Medication in PACU

Background: Opioids have long been a mainstay for postoperative pain management; however, their side effects are causing providers to reconsider opioid-free techniques. Nonopioid agents, such as esketamine, dexmedetomidine, and ketorolac, have found increased use. Pediatric tonsillectomy is frequently complicated by pain postoperatively, delayed oral intake, and caregiver dissatisfaction. Objective: To evaluate whether an opioid-free regimen improved postoperative pain, recovery outcomes, and caregiver satisfaction compared with traditional opioid-based anesthesia. Design: Prospective, randomized, single-blinded clinical trial. Participants/Methods: 44 children, aged 3 to 7 years, presenting for tonsillectomy were randomized into either the control or experimental groups. Induction and adjunct medications were standardized. Patients in the control group received a bolus of fentanyl with a remifentanil maintenance infusion, while those in the experimental group received boluses of dex more...