2021
DOI: 10.1186/s13023-021-01795-4
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Opioid-free anesthesia for patients with joint hypermobility syndrome undergoing craneo-cervical fixation: a case-series study focused on anti-hyperalgesic approach

Abstract: Background Patients with Ehlers-Danlos Syndrome/Hypermobility Type (EDS-HT/JHS) and Craneo-Cervical Instability frequently suffer from severe widespread pain which is difficult to control. Chronic neuroinflammation, opioid-induced hyperalgesia, and central sensitization may explain this painful condition. The aim of this study was to determine if opioid-free anesthesia plus the postoperative administration of lidocaine, ketamine and dexmedetomidine can reduce postoperative pain and the need of … Show more

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Cited by 7 publications
(22 citation statements)
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“…In a case-series study of 42 patients with JHS that have undergone OCF [39], the authors found a lower VAS in the OFA group in the postoperative time (p < 0.001). The reduction in the VAS was more significanton the 1st postoperative day in the OFA group 5.35 (4.83-5.86) vs. the Opioid group (OP) 7.89 (7.56-8.23) (p < 0.001), meaning up to 32% decrease in the VAS of the OFA group.…”
Section: Is It Feasible To Provide a Perioperative Management Focusing On Anti-hyperalgesia And Central Sensitization For Patient With Chmentioning
confidence: 94%
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“…In a case-series study of 42 patients with JHS that have undergone OCF [39], the authors found a lower VAS in the OFA group in the postoperative time (p < 0.001). The reduction in the VAS was more significanton the 1st postoperative day in the OFA group 5.35 (4.83-5.86) vs. the Opioid group (OP) 7.89 (7.56-8.23) (p < 0.001), meaning up to 32% decrease in the VAS of the OFA group.…”
Section: Is It Feasible To Provide a Perioperative Management Focusing On Anti-hyperalgesia And Central Sensitization For Patient With Chmentioning
confidence: 94%
“…Therefore, considering the probable mechanisms of the chronic pain (CS and OIH) that affect patients with JHS and CCI as well as their frequent association with MCAS and POTS, the use of opioids in total intravenous anesthesia (TIVA) during occipitocervical~thoracic fixation (OCF) was halted in our practice. Intra-operative opioid-based analgesia has been replaced by infusions of lidocaine, ketamine, magnesium, dexmedetomidine and propofol as hypnotic [10,39]. As stated before, they are coadjuvants with known anti-hyperalgesic properties.…”
Section: Is It Feasible To Provide a Perioperative Management Focusing On Anti-hyperalgesia And Central Sensitization For Patient With Chmentioning
confidence: 99%
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