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Suzetrigine has generated understandable enthusiasm as a first-in-class, non-opioid analgesic targeting peripheral Nav1.8 sodium channels. For perioperative clinicians seeking alternatives to opioid-centered pain management, this mechanism is attractive. Yet two distinct challenges must be considered in parallel: (1) whether suzetrigine demonstrates meaningful effectiveness in complex surgical populations and (2) how it can be introduced safely into the complex realities of perioperative care.