随着对阿片药认识的不断加深和加速康复外科（enhanced recovery after surgery, ERAS）的发展，无阿片药麻醉（opioid-free anesthesia, OFA）在临床应用越来越多。OFA是基于多模式麻醉理念，通过相关药物和/或方法来提供一个无阿片药的优质全身麻醉。许多病例报道和研究显示OFA安全可行，并可减少阿片药相关副作用。文章就OFA的概念、OFA的优势、OFA的适应证、相关药物选择（如右美托咪定、氯胺酮、利多卡因、硫酸镁、非甾体抗炎药等）及麻醉方法进行综述。OFA作为一种新的麻醉样式，其更多的益处和对患者近远期的影响有待观察，临床常规应用还存在一定争议。“,”With the growth of the understanding of opioids and the improvement of enhanced recovery after surgery (ERAS), more and more patients have been used opioid-free anesthesia (OFA). OFA is multimodal anesthesia associating drugs and/or techniques that allow a good quality general anesthesia with no need for opioids. Some case reports and studies are showing that OFA is feasible and safe and decreases the risk of common opioid-relative adverse effects. This article reviews the definite, benefits and indications of OFA, selection of analgesic drugs (dexmedetomidine, ketamine, lidocaine, magnesium sulfate, anti-inflammatory drugs, etc), and methods of anesthesia. OFA as a new paradigm, there is a need for more research on benefits and both early and long-term outcome after surgery. To support the clinic routine use of OFA has still a debate.