Opioid-Free Balanced Anesthesia for Cervical Ganglionectomy Subsequent to Recent Ultra Rapid Opioid Detoxification

Abstract

This patient successfully completed a perioperative and postoperative course using ketamine and dexmedetomidine infusions, in addition to other non-opioid adjuncts. The patient returned to her Active Duty station, with increased functional capacity and remains opioid-free.

Opioid Sparing Anaesthesia for Living-Donor Renal Transplantation-A Case Report

“…Balanced anaesthesia using multiple synergistic agents can attain these goals while minimizing the side effects that may result from high doses of a single agent [1,3]. Opioids are fundamental drugs to achieve a balanced anaesthesia, however, there are clinical situations in which their use is relatively contraindicated, such as opioid intolerance and allergy [1].…”

“…Specifically, opioids given during the perioperative period, or their active metabolites, depend on renal excretion and may accumulate depending on the perfusion and function of the new graft [1]. Therefore, alternatives to use of opioids should be used.…”

“…Meanwhile, the analgesic properties of non-opioid drugs increased the practice of intraoperative multimodal analgesia leading to a global decrease in the consumption of analgesics in the postoperative period. The better knowledge of pain mechanisms and chronic pain treatments is useful to anaesthesiologists when faced with patients who are intolerant to opioid drugs [1].…”

“…Renal transplantation is the ideal treatment for end stage renal disease (ESRD) which is the last stage of chronic kidney disease (CKD) caused most frequently by glomerulonephritis, chronic interstitial nephritis or obstructive syndromes, hereditary or cystic disease [1,4].…”