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Nonopioid analgesics are needed for postoperative pain management due to side effects of opioid analgesics, which hinder recovery, especially with the increased utilization of ambulatory surgical procedures. Of great benefit are the NSAIDs and the COX-2 inhibitors, which lead to about 30% to 40% reduction in opioid use for postoperative pain relief. NMDA antagonists have psychomimetic side effects at high doses, but at moderate doses do not cause stereotypic behavior but allow reduction in opioid dose to obtain better pain control.
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