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Integrating complementary medicine in the perioperative period: a simple, opioid-sparing addition to your multimodal analgesia strategy?
  1. Deirdre C Kelleher1,
  2. Meghan A Kirksey1,2,
  3. Christopher L Wu1,2 and
  4. Stephanie I Cheng1,2
  1. 1Department of Anesthesiology, Weill Cornell Medical College, New York, New York, USA
  2. 2Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
  1. Correspondence to Dr Deirdre C Kelleher, Department of Anesthesiology, Weill Cornell Medical College, New York, NY 10065, USA; dck7002{at}


The current US opioid health-related crisis underscores the importance for perioperative physicians to optimize various approaches to pain management. Multimodal techniques and enhanced recovery after surgery (ERAS) protocols are frequently cited as the most effective strategies for improving the experience of pain and reducing opioid exposure. Complementary medicine (CM) techniques, while frequently shown to be effective at reducing opioid and other pharmacologic agent use, are rarely discussed as part of these multimodal strategies. In general, CM therapies are low-cost with minimal associated risk, making them an ideal choice for incorporation into ERAS and other opioid-sparing protocols. In this Daring Discourse, we discuss the benefits and challenges of incorporating CM therapy into anesthetic practice. We hope that anesthesiologists can become more familiar with the current evidence regarding perioperative CM therapy, and begin incorporating these therapies as part of their comprehensive multimodal approach to perioperative pain management.

  • alternative therapies
  • acute pain
  • postoperative pain
  • opioids, adverse effects

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  • Contributors All authors have made substantial contributions to the conception of this work, drafting and revising it critically for important intellectual content, and have given final approval of the version published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved, with DCK being the corresponding author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.