Background: The World Health Organization (WHO) defines obesity as “a condition in which percentage body fat (PBF) is increased to an extent in which health and well-being are impaired, and, due to the alarming prevalence increase, declared it as a “global epidemic” Overweight and obesity were estimated to afflict nearly 1.5 billion adults worldwide in 2008 , predicted in 2030 globally an estimated 2.16 billion adults will be overweight, and 1.12 billion will be obese. Multimodal analgesia involves the use of different classes of analgesic medications (NSAIDs, COX2 inhibitors, gabapentinoids, or acetaminophen in combination with morphine IV-PCA) with different mechanisms of action on the peripheral and/or central nervous system. The different combinations of these drugs lead to additive or synergistic effects on pain relief and can potentially reduce the side effects of mono-modal interventions. Ketamine is recommended in severe pain management, and subanesthetic doses considered to have evidence of efficacy in acute pain are boluses < 0.35 mg/kg and infusions at 0.5-1 mg/kg/h, with no intensive monitoring required. Dexmedetomidine in postoperative pain for Opioid‐sparing seem a promising avenue by which to improve postoperative outcomes