Despite the advances in pediatric anesthesia, infants have higher mortality and critical incidents rates than children, especially ex-prematures and those with comorbidity. We present the case of a high-risk infant who underwent elective laparoscopic gastrostomy under opioid-free anesthesia (OFA) combined with transversus abdominis plane (TAP) block with Dexmedetomidine (DEX). Perioperative opioids were entirely avoided, and intraoperative anesthetics and postoperative analgesic were considerably reduced. The infant showed cardiorespiratory stability and optimal analgesia during the uneventful procedure and the postoperative period. We consider OFA and TAP block with DEX a safe and effective anesthetic combination for high-risk infants.
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http://dx.doi.org/10.4103/sja.sja_319_21 | DOI Listing |
Int J Gen Med
December 2024
Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Purpose: The routine perioperative use of opioids has recently been questioned due to opioid-related side effects, which can be potentially harmful in geriatric patients. This study aimed to evaluate the effects of opioid-free anesthesia in geriatric patients undergoing hip surgery.
Patients And Methods: A total of 121 patients, aged 60 years or older, undergoing elective hip surgery were randomized to receive either opioid-free anesthesia with dexmedetomidine and esketamine (OFA group) or balanced anesthesia with opioids (CON group).
J Clin Anesth
December 2024
Department of Anesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address:
Study Objective: VVZ-149 is a small molecule that inhibits the glycine transporter type 2 and the serotonin receptor 5-hydroxytryptamine 2 A. In this Phase 3 study, we investigated the efficacy and safety of VVZ-149 as a single-use injectable analgesic for treating moderate to severe postoperative pain after laparoscopic colectomy.
Design: Randomized, parallel group, double-blind, Phase 3 clinical trial (Trial no.
J Clin Med
November 2024
Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Opioid-sparing anesthesia (OSA) using dexmedetomidine has gained attention as an alternative to opioid-based anesthesia (OBA) due to its potential to reduce opioid consumption and the associated side effects. This study aimed to investigate the effect of dexmedetomidine-based OSA on postoperative pain intensity, opioid consumption, and recovery outcomes in patients undergoing a minimally invasive repair of pectus excavatum. Eighty-four patients undergoing a minimally invasive repair of pectus excavatum were randomized to either the OSA group, receiving dexmedetomidine, or the OBA group, receiving remifentanil.
View Article and Find Full Text PDFAnaesth Crit Care Pain Med
December 2024
Department of Anaesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address:
Background: There is still debate over whether opioid-free anaesthesia (OFA) can improve the patient-reported quality of recovery (QoR).
Methods: A search was conducted across Pubmed, Cochrane Library, and EMBASE until June 2024 for randomized controlled trials comparing the impact of OFA and opioid-based anaesthesia (OBA) on QoR in adult patients undergoing general anaesthesia. The primary outcome was the quality of recovery measured with the QoR scale.
Paediatr Anaesth
December 2024
Department of Anaesthesiology and Intensive Care, Children's Health Ireland at Crumlin, Dublin, Ireland.
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