Enhanced Recovery in Bariatric Surgery through Opioid-Free Anesthesia: A Clinical Case Report

Abstract

Opioid-free anesthesia management was a new aspect explored in this case study report concerning a 32-year-old male who underwent laparoscopic sleeve gastrectomy. Pre-anesthesia evaluation was a general medical examination seeking to capture his medical information and his physical condition. Concurrently, in the operating room (OR) opioid-free anesthesia was secured with dexmedetomidine, lidocaine, magnesium sulfate, propofol and ketamine; which was propelled by sevoflurane maintenance. Subsequently, post-operatively, titrated infusion of dexmedetomidine and ketamine with respect to patient-controlled analgesia proved to be more effective in controlling pain than opioids and the patient was hemodynamically well-stabilized and also better avoided side-effects associated with opioids. This case evidenced that it is possible and beneficial to create care pathways without opioids to substitute for pain and opioid medication control. It is also a successful part of the Enhanced Recovery After Surgery (ERAS) framework.

Keywords: Bariatric surgery, dexmedetomidine, enhanced recovery after surgery, ketamine, opioid-sparing analgesia