Opioid-free anesthesia(OFA)is a multimodal analgesic strategy that combines multiple non-opioid drugs and/or techniques to obtain high-quality anesthesia.With the popularization of the concept of enhanced recovery after surgery(ERAS),OFA has become a common concern hot spot for perioperative phy-sicians.OFA is in line with the ERAS concept,and under multimodal anesthesia and pain management,it can reduce surgical stress,inflammation reaction and postoperative complications,significantly improve the prog-nosis of patients,promote postoperative rapid recovery and reduce the burden of medical and health resources.This article reviews the adverse reactions of opioids,OFA concept and indications,the clinical application of OFA in recent years,the existing controversies and problems to be solved.