ENHANCED RECOVERY AFTER SURGERY (ERAS) PROTOCOLS AND POSTOPERATIVE PAIN OUTCOMES: A LITERATURE REVIEW OF OPIOID-SPARING ANALGESIA IN ADULT SURGICAL PATIENTS

Background: Pain management is an integral part of recovery after surgical procedures and remains one of the key components of modern perioperative care. Opioid therapy is an effective method for alleviating moderate to severe postoperative pain and has traditionally been considered a cornerstone of perioperative analgesia. However, growing evidence suggests that opioid-based pain management is associated with numerous adverse effects. In response to these concerns, Enhanced Recovery After Surgery (ERAS) protocols were introduced to optimize perioperative care and reduce the physiological stress response associated with surgical procedures. Aim: The aim of this literature review was to evaluate the impact of Enhanced Recovery After Surgery (ERAS) protocols on postoperative pain outcomes, opioid consumption, and recovery quality in adult patients undergoing surgical procedures. Material and methods: A literature search was performed using PubMed, Google Scholar, PMC, and ScienceDirect databases, along with a manual search of selected scientific journals to identify eligible studies. Results: The majority of the 20 reviewed studies demonstrated that ERAS protocols reduce postoperative opioid consumption while maintaining adequate pain control. Several randomized clinical trials and cohort studies additionally showed lower pain scores, earlier mobilization, reduced postoperative nausea and vomiting, faster gastrointestinal recovery, and shorter length of hospital stay in ERAS groups compared with conventional perioperative care. Conclusion: ERAS protocols positively influence postoperative pain outcomes and recovery quality in surgical patients. Opioid-sparing multimodal analgesia appears to reduce opioid-related complications while preserving effective postoperative pain control. Further large-scale randomized clinical trials are required to establish standardized analgesic pathways for different surgical specialties.