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Background and Aims Opioid Free Anesthesia (OFA – Opioid Free Anesthesia) is an alternative technique that uses only non-opioid analgesics, thus avoiding the complications associated to opioid use.
Methods We present the case of a 65-year-old patient with grade II obesity (BMI= 36.8), with personal pathological history reveals two surgeries: laparoscopic cholecystectomy and L4-L5 lumbar disc herniation, both under balanced general anesthesia with oro-tracheal intubation. Immediately postoperatively, the patient presented episodes of nausea, vomiting, dizziness and respiratory depression – events that are documented in the patient’s medical files. Based on the patient’s history, it was decided to perform the surgical intervention (left radical nefrectomy) under OFA using propofol, ketamine, rocuronium potentated by volatile anesthetic (sevofurane). The induction of general anesthesia included midazolam 3 mg, lidocaine hydrochloride 80 mg, propofol 160 mg, ketamine hydrochloride 40 mg, and rocuronium bromide 60 mg. After tracheal intubation continuous intravenous infusion of lidocaine hydrochloride 2 mg/kg/h was started, and magnesium sulfate (MgSO4) 1.5 gr/h.
Results The patient was pain-free (VAS score 1) no nausea, vomiting, or dizziness complaining. Postoperative analgesia plan included 1g of paracetamol for VAS score from 3 to 5, or 20 mg nefopam for VAS score from 6 to 8, while diclofenac 75 mg was used as a rescue analgesic.
Conclusions This case demonstrates that OFA could be an alternative in developing a strategy to improve the postoperative recovery of patients with a history of low tolerance to opioid analgesics, meeting the criteria of e?ciency and safety.
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