It serves as evidence of compassionate concern for patients and dedication to improving practice that several letters1–3  were received in response to the articles by Beloeil et al. and Shanthanna et al. on opioid-free anesthesia, and to our accompanying editorial. The topic of opioid-free anesthesia is one of intense interest to the field, and these articles are commended to the reader. Those points made in the letters specific to our editorial are addressed briefly below.

The letter by Chelly reminds us that we are perioperative physicians and that optimal postoperative analgesia might begin with a preoperative intervention. Addressing psychological factors linked to pain and elevated analgesic requirements is suggested, proposing complementary strategies such as acupuncture, music therapy and others. We agree that any potential opportunity for early intervention is not to...

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