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Revista Cubana de Anestesiología y Reanimación

ISSN 1726-6718 (Electronic)
Revista Cubana de Anestesiología y Reanimación
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2022, Number 2

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Revista Cubana de Anestesiología y Reanimación 2022; 21 (2)

Opioid-free total intravenous anesthesia guided by qCON y qNOX in a female obese patient

Cevallos SFA, Puga BCE, Morocho REA, Molineros MLA
Full text How to cite this article

Language: Spanish
References: 16
Page: 1-9
PDF size: 315.84 Kb.


Key words:

total intravenous anesthesia, opioid-free anesthesia, hypnosis, pain, plasma concentration, pharmacokinetic model.

ABSTRACT

Introduction: In recent years, opioid-free anesthesia has become another alternative in front of traditional general anesthesia techniques. The exclusion of this group of drugs avoids the numerous adverse effects and complications associated with its usage. Although opioid-free anesthesia has its indications and has showed its benefits in a certain group of patients, there is still controversy regarding its usefulness in the obese patient. Characteristics such as obesity make the multimodal models used to program opioid-free anesthesia increasingly complex.
Objectives: To describe a clinical case involving the opioid-free anesthesia technique, which is the first experience in Ecuador.
Case presentation: The case is presented of a female obese patient who underwent laparoscopic cholecystectomy by infusion of propofol, ketamine, lidocaine, magnesium sulfate and dexmedetomidine. Titration of these drugs was carried out by calculating plasma concentrations through pharmacokinetic models and guided by monitoring of anesthetic and analgesic depth, thus optimizing drug consumption, reducing complications and achieving a favorable clinical evolution. As far as known locally and in the country (Ecuador), this is the first reported experience with this technique.
Conclusions: Opioid-free anesthesia may be a choice in the obese patient, since it ensures adequate recovery without associated adverse effects.


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Revista Cubana de Anestesiología y Reanimación. 2022;21