Background: Postoperative pain can interfere with early mobilization and delay participation in structured rehabilitation after major surgery. Systemic opioid analgesia, the historical standard, carries adverse effects such as sedation, respiratory depression, postoperative nausea and vomiting, and opioid-induced ileus, which may directly delay functional recovery. Regional anesthesia techniques, including peripheral nerve blocks, neuraxial blockade, and ultrasound-guided interfascial plane blocks, offer opioid-sparing alternatives while preserving motor function essential for rehabilitation.

Objective: To evaluate the influence of regional anesthesia on postoperative functional recovery and early rehabilitation outcomes compared with conventional systemic analgesia. This review contributes a cross-specialty synthesis that frames analgesic technique selection as a rehabilitation decision, an orientation not emphasized in prior specialty-specific reviews.

Methods: A structured search of PubMed, CINAHL, the Cochrane Library, and Embase identified English-language randomized controlled trials, prospective cohort studies, and systematic reviews published between January 2015 and December2024. Seminal pre-2015 references identified through hand-searching of included articles were retained where they represented foundational evidence. Studies enrolled adult surgical patients and reported at least one functional outcome, including pain scores, opioid consumption, time to ambulation, physical therapy participation, or hospital length of stay (LOS).

Results: Across orthopedic, abdominal, and thoracic surgical populations, regional anesthesia consistently provided superior analgesia and reduced opioid requirements versus systemic regimens. Quadriceps-sparing peripheral nerve blocks accelerated rehabilitation milestones in arthroplasty, while epidural and interfascial plane blocks reduced ileus and enhanced pulmonary recovery in abdominal and thoracic procedures. When integrated within Enhanced Recovery After Surgery (ERAS) protocols, regional techniques were associated with substantial reductions in LOS.

Conclusion: Regional anesthesia is a cornerstone of evidence-based perioperative analgesia and is associated with improved functional recovery. Broader integration within multimodal care pathways should be prioritized, with future research focused on standardized outcome measures and expanded access in community practice.