Multimodal analgesia as a key strategy to reduce opioid exposure and optimise postoperative outcomes in perioperative practice: a scoping review.

Introduction: Postoperative pain remains a relevant clinical problem associated with increased morbidity, greater healthcare resource utilisation and extensive opioid use during the perioperative period. In response to these limitations, multimodal analgesia has been widely incorporated into clinical practice. Nevertheless, the available evidence is heterogeneous and fragmented, hindering a comprehensive understanding of the regimens employed, the surgical contexts in which they are applied, and the postoperative outcomes assessed. Methodology: A scoping review will be conducted in accordance with the recommendations of the Joanna Briggs Institute and reported following the PRISMA-ScR guideline. A structured search will be carried out in PubMed, Scopus and Web of Science to identify studies published between 2015 and 2025 in English or Spanish. Primary studies describing or evaluating multimodal analgesia strategies in adult patients undergoing surgery will be included. Study selection and data extraction will be performed independently by two reviewers. Evidence synthesis will be descriptive and narrative, without formal risk of bias assessment or meta-analysis. Expected results: It is expected to map a wide range of multimodal analgesia regimens, demonstrating considerable heterogeneity in analgesic components, timing of administration and surgical contexts of application. In addition, the most frequently evaluated postoperative outcomes and the main knowledge gaps in the existing literature are anticipated to be identified.