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自2017年美国发生“阿片危机”之后，于2018至2020年先后提出了“无阿片麻醉”（OFA）和“少阿片麻醉”（ORA）的建议。OFA是一种极端的阿片节俭技术，而ORA则是阿片类药的集约化应用。事实上我们目前还离不开阿片类药，所以ORA更符合当前麻醉的现状。在ORA中神经阻滞+多模式镇静/镇痛能显著减少阿片类药用量及其不良反应。我们应开发更多更好的非阿片类镇痛药和新技术，OFA应从ORA开始做起。“,”After the “opioid crisis” in USA in 2017, “opioid free anesthesia (OFA)” and “opioid reduced anesthesia (ORA)” have been proposed successively between 2018 and 2020. OFA is an extreme technique of no opioids and ORA is an intensive use of opioids. In fact, the opioids can\'t remove from anesthesia at present, therefore, ORA may be in accord with current situation of anesthesia. Nerve block + multimodel sedation/analgesia can obviously decrease the dosage of opioids and the adverse reactions with ORA. More and better non-opioid analgesics and new techniques should be developed, and OFA should begin with ORA.