Is an opioid-free anaesthesia possible without using alpha-2 agonists?

Opioid-free anaesthesia: The conundrum and the solutions

“…OFA/OSA also offers particular advantages in opioid tolerant patients such as patients with chronic pain, cancer-related pain and patients suffering from opioid addiction. [ 9 ] It has also been observed that the chronic use of opioids as in cancer patients further compromises the immune system by decreasing the progenitor cells of lymphocytes and macrophages. They also suppress T cell–mediated immunity.…”