MULTIMODAL ANALGESIA: BEYOND PAIN CONTROL

Pain management represents a persistent clinical challenge due to its multifactorial nature and the limitations of traditional analgesic approaches based on a single mechanism of action, particularly the predominant use of opioids.In this context, multimodal analgesia has emerged as a comprehensive therapeutic strategy that combines pharmacological and non--pharmacological interventions targeting different pathophysiological targets of pain, with the aim of optimizing analgesic efficacy and improving patient safety.This narrative review analyzes multimodal analgesia from a global perspective, integrating pathophysiological fundamentals, mechanisms of action, and current clinical evidence.It examines the modulation of opioid receptors, the inhibition of peripheral inflammation, the attenuation of central sensitization, and the role of descending modulatory systems, as well as the contribution of non-pharmacological therapies to the pain experience.The available evidence suggests that the rational combination of these strategies reduces opioid exposure, decreases the incidence of adverse effects, and limits phenomena such as hyperalgesia and chronic pain.Beyond controlling pain intensity, multimodal analgesia has an impact on relevant clinical and functional outcomes, including the preservation of respiratory and neurocognitive function, improved mobility, and functional recovery., multimodal analgesia should be understood as a personalized, mechanism-based strategy aimed at improving safety, functionality, and the overall patient experience, beyond simple pain relief.