Multimodal analgesia model to achieve low postoperative opioid requirement following bariatric surgery

Lam, Katherine KY; Mui, Wilfred L. M.

doi:10.12809/hkmj154769

Cited by 21 publications

(12 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Also, OFA can be used in obese patients scheduled for bariatric surgery, therefore serves for avoiding opioids as this group of patients are particularly in risk to develop respiratory depression 32 . Majority of obese patients have obstructive sleep apnoea syndrome (OSA) and they are prone to airway obstruction and desaturation in the perioperative period, especially if opioids are given.…”

Section: Discussionmentioning

confidence: 99%

Practicing opioid-free anesthesia for laparoscopic cholecystectomy opioid-free anesthesia

Toleska¹,

Карталов²,

Кузмановска³

et al. 2019

Serb J Anest Inten Therapy

View full text Add to dashboard Cite

Introduction: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 underwent two surgical interventions; bilateral radical mastectomy performed separately with a three year gap. Both anesthesias 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, continuous 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 given 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.

show abstract

Section: Discussionmentioning

confidence: 99%

Practicing opioid-free anesthesia for laparoscopic cholecystectomy opioid-free anesthesia

Toleska¹,

Карталов²,

Кузмановска³

et al. 2019

Serb J Anest Inten Therapy

View full text Add to dashboard Cite

show abstract

“…At our institution, opioids form the basis of the perioperative analgesic regimen for children undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, and a multimodal approach is typically introduced only when postoperative opioid requirements increase. However, multimodal analgesia has been associated with improved pain scores and reduced opioid consumption in several studies . Of particular interest in this patient population may be the early inclusion of anti‐hyperalgesic agents such as methadone, ketamine, and dexmedetomidine.…”

Section: Discussionmentioning

confidence: 99%

“…However, multimodal analgesia has been associated with improved pain scores and reduced opioid consumption in several studies. [16][17][18][19] Of particular interest in this patient population may be the early inclusion of anti-hyperalgesic agents such as methadone, ketamine, and dexmedetomidine. There is evidence to suggest that NMDA receptor antagonism by these agents may prevent opioid-induced hyperalgesia and reduce acute tolerance to the analgesic effects of opioids.…”

mentioning

confidence: 99%

Perioperative factors associated with persistent opioid use after extensive abdominal surgery in children and adolescents: A retrospective cohort study

Owusu-Agyemang

Cata

Meter

et al. 2018

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…Physiological aspects include OSA, a main risk factor in preoperative hypoxia, different biodistribution of medical compounds and cardiovascular impairments. The use of Lean Body Weight LBW appears to be a more accurate way to determine dosage and prescription by excluding body fat from the total body weight equation [5,22].…”

Section: Discussionmentioning

confidence: 99%

“…Also, no statistically significant differences in pain perception or the need for rescue medication were evidenced [13]. Table 3: Multimodal Analgesia Protocol Lam et al [22].…”

Section: Local Anesthetics: Port Site Infiltrationmentioning

confidence: 98%

Pain Management in Weight Loss Surgery: Aiming for Multimodal Approach

Gamboa¹

2016

AOWMC

View full text Add to dashboard Cite

Weight loss surgery (WLS) is an effective group of procedures with a low rate of complications, preventing or treating several cardiovascular co morbidities associated with morbid obesity. Pain management in the preoperative needs special consideration in this population because of different aspects, specially the theoretical need for opioid avoidance, generally used in the postoperative of major surgeries. This literature review assesses the available information on analgesic strategies for WLS, with a special approach on multimodal settings and possible alternatives. Well-controlled studies are needed to determine the level of recommendation for individual therapies and multimodal regimens.

show abstract

Multimodal analgesia model to achieve low postoperative opioid requirement following bariatric surgery

Cited by 21 publications

References 18 publications

Practicing opioid-free anesthesia for laparoscopic cholecystectomy opioid-free anesthesia

Practicing opioid-free anesthesia for laparoscopic cholecystectomy opioid-free anesthesia

Perioperative factors associated with persistent opioid use after extensive abdominal surgery in children and adolescents: A retrospective cohort study

Pain Management in Weight Loss Surgery: Aiming for Multimodal Approach

Contact Info

Product

Resources

About