An Evidence-Based Opioid-Free Anesthetic Technique to Manage Perioperative and Periprocedural Pain

The epidemic of opioid abuse is increasing, and the number of deaths secondary to opioid overdose is also increasing. Recent attention has focused on opioid prescribing and management of chronic pain. However, opioid use in perioperative and periprocedural patients, whether they have chronic pain or...

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Bibliographic Details
Published in:The Ochsner journal 2018-01, Vol.18 (2), p.121-125
Main Authors: Boysen, 2nd, Philip G, Pappas, Marisa M, Evans, Bryan
Format: Article
Language:English
Subjects:
Analgesics
Anesthesia
Anesthesiology
Delirium
Drug dosages
Intensive care
Lipids
Mortality
Narcotics
Nitrous oxide
Nonsteroidal anti-inflammatory drugs
Opioid Stewardship
Pain
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Summary:The epidemic of opioid abuse is increasing, and the number of deaths secondary to opioid overdose is also increasing. Recent attention has focused on opioid prescribing and management of chronic pain. However, opioid use in perioperative and periprocedural patients, whether they have chronic pain or exhibit new persistent opioid abuse after a procedure, has received little attention. We present an evidence-based technique that combines subanesthetic infusions of lidocaine and dexmedetomidine supplemented with other intravenous agents and a low dose of inhaled anesthetic. Based on evidence of drug action and interaction, an opioid-free anesthetic can be delivered successfully. We present the cases of 2 patients in whom the opioid-free anesthetic technique was used with a successful outcome, adequate pain management, and avoidance of opioid drugs. This anesthetic prescription can be useful for opioid-naïve patients as well as for patients with chronic pain that is managed with opioids.
ISSN:1524-5012
1524-5012
DOI:10.31486/toj.17.0072