Practicing opioid-free anesthesia for laparoscopic cholecystectomy opioid-free anesthesia

• DOI: 10.5937/sjait1906107t
• Publication Date: 2020-02-18T18:29:48Z
• Authors: Marija Toleska; Andrijan Kartalov; Biljana Kuzmanovska; Vladimir Joksimović; Aleksandar Dimitr...; Filip Naumovski
• Keywords: Midazolam; Ketamine hydrochloride

Opioid free anesthesia (OFA) is an anesthesiological technique, which uses non-opioid analgesics, such as paracetamol, Dexamethasone, lidocaine, ketamine, and magnesium sulfate instead of opioids. In this case, the report about patient who after previous surgeries experienced opioid side effects followed by a narrative review; we present OFA method for laparoscopic cholecystectomy. Case report: We case 55-year-old woman with history controlled hypertension asthma, planned Previously she underwent two surgical interventions; bilateral radical mastectomy performed separately three year gap. Both anesthesias were complicated, postoperatively nausea, vomiting, dizziness, respiratory depression. Based on postoperative complications, hypothesized that depression caused opioids, decided to perform OFA. Before induction received Dexamethasone 8 mg paracetamol 1 gr intravenously, midazolam 3 mg, lidocaine hydrochloride 78 propofol 160 ketamine 39 rocuronium bromide 60 mg. After tracheal intubation, continuous intravenous infusion 2 mg/kg/hr 1.5 gr/hr was started. Anesthesia maintained using sevoflurane MAC 0.7-1. At end surgery, 2.5 metamizole given intravenously. Postoperative recovery uneventful. Conclusion: our patient, eliminated opioid-related (nausea, shortness breath), provided satisfying analgesia.