Subject: opioid free anesthesia
Subject: laparoscopic cholecystectomy
Subject: pain
Subject: nausea
Subject: vomiting
Year: 2019
Type: Article
Title: Practicing opioid-free anesthesia for laparoscopic cholecystectomy opioid-free anesthesia
Author: Marija Toleska
Author: Andrijan Kartalov
Author: Biljana Kuzmanovska
Author: Vladimir Joksimovic
Author: Aleksandar Dimitrovski
Author: Filip Naumovski
Abstract: ntroduction: 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 is followed by a narrative review; we present the OFA method for laparoscopic cholecystectomy. Case report: We present a case of a 55-year-old woman with a history of controlled hypertension and asthma, planned for laparoscopic cholecystectomy. Previously she un-derwent two surgical interventions; bilateral radical mastectomy performed separately with a three year gap. Both an-esthesias were complicated, postoperatively with nausea, vomiting, dizziness, and respiratory depression. Based on the previous postoperative complications, we hypothesized that nausea, vomiting, dizziness, and respiratory depression were caused by opioids, and we decided to perform OFA. Before the induction the patient received dexamethasone 8 mg and paracetamol 1 gr intravenously, followed by induction with midazolam 3 mg, lidocaine hydrochloride 78 mg, propofol 160 mg, ketamine hydrochloride 39 mg and rocuronium bromide 60 mg. After tracheal intubation, con-tinuous intravenous infusion with lidocaine hydrochloride 2 mg/kg/hr and magnesium sulfate 1.5 gr/hr was started. Anesthesia was maintained by using sevoflurane MAC 0.7–1. At the end of the surgery, 2.5 gr of metamizole was giv-en intravenously. Postoperative recovery was uneventful. Conclusion: In our patient, OFA eliminated opioid-related side effects (nausea, vomiting, dizziness, and shortness of breath), and provided satisfying postoperative analgesia
Publisher: Centre for Evaluation in Education and Science
Relation: Serbian Journal of Anesthesia and Intensive Therapy
Identifier: oai:repository.ukim.mk:20.500.12188/8949
Identifier: 2217-7744
Identifier: http://hdl.handle.net/20.500.12188/8949Identifier: 2466-488X
