加速康复外科（ERAS）通过优化围手术期管理策略，显著改善了患者预后。作为ERAS的核心环节，多模式镇痛（MMA）通过联合不同机制的镇痛药物和技术，在有效控制术后疼痛的同时，减少阿片类药物用量及相关不良反应。本文系统回顾了MMA在不同外科领域（腹部、骨科、胸外科手术）的具体应用方案及临床价值，分析了当前面临的个体化镇痛不足、技术推广不均等挑战，并探讨了基于精准医学、新型药物和智能技术的未来发展方向。临床实践表明，MMA通过优化镇痛方案促进患者早期康复，是ERAS成功实施的重要保障。

Enhanced recovery after surgery (ERAS) significantly improves patient outcomes by optimizing perioperative management strategies. As a core component of ERAS, multimodal analgesia (MMA) integrates analgesic agents and techniques with different mechanisms of action to achieve effective postoperative pain control while reducing opioid consumption and opioid-related adverse effects. This article systematically reviews the specific applications and clinical value of MMA across various surgical specialties, including abdominal, orthopedic, and thoracic surgeries. Current challenges—such as insufficiently individualized analgesic strategies and uneven implementation of advanced techniques—are analyzed, and future directions based on precision medicine, novel analgesic agents, and intelligent technologies are discussed. Clinical practice demonstrates that MMA facilitates early postoperative recovery through optimized analgesic regimens and represents critical foundation for the successful implementation of ERAS.