Opioid-free anesthesia in oncologic surgery: the rules of the game

Alessandro De Cassai; Federico Geraldini; Serkan Tulgar; Ali Ahiskalioglu; Edward R. Mariano; Burhan Dost; Pierfrancesco Fusco; Gian Marco Petroni; Fábio Costa; Paolo Navalesi

doi:10.1186/s44158-022-00037-8

journal article Open Access Feb 05, 2022

Opioid-free anesthesia in oncologic surgery: the rules of the game

Alessandro De Cassai

Federico Geraldini

Serkan Tulgar

Ali Ahiskalioglu

Edward R. Mariano Burhan Dost

Pierfrancesco Fusco

Gian Marco Petroni

Fábio Costa Paolo Navalesi

Journal of Anesthesia, Analgesia and Critical Care Vol. 2 No. 1 · Springer Science and Business Media LLC

View at Publisher Save 10.1186/s44158-022-00037-8

Abstract

Abstract
Background
Opioids are frequently used in the postoperative period due to their analgesic properties. While these drugs reduce nociceptive somatic, visceral, and neuropathic pain, they may also lead to undesirable effects such as respiratory depression, urinary retention, nausea and vomiting, constipation, itching, opioid-induced hyperalgesia, tolerance, addiction, and immune system disorders. Anesthesiologists are in the critical position of finding balance between using opioids when they are necessary and implementing opioid-sparing strategies to avoid the known harmful effects. This article aims to give an overview of opioid-free anesthesia.

Main body
This paper presents an overview of opioid-free anesthesia and opioid-sparing anesthetic techniques. Pharmacological and non-pharmacological strategies are discussed, highlighting the possible advantages and drawbacks of each approach.

Conclusions
Choosing the best anesthetic protocol for a patient undergoing cancer surgery is not an easy task and the available literature provides no definitive answers. In our opinion, opioid-sparing strategies should always be implemented in routine practice and opioid-free anesthesia should be considered whenever possible. Non-pharmacological strategies such as patient education, while generally underrepresented in scientific literature, may warrant consideration in clinical practice.

Topics

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Published: Feb 05, 2022
Vol/Issue: 2(1)
License: View

Authors

A

Alessandro De Cassai

Department of Medicine (DIMED), University of Padua, Padua, Italy; Institute of Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy

Department of Anaesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey

Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Türkiye

P

Pierfrancesco Fusco

Anesthesia and Intensive Care Unit, SS Filippo e Nicola Hospital, Avezzano, L’Aquila, Italy

G

Gian Marco Petroni

Anesthesia and Intensive Care Unit, Santa Maria Hospital, Terni, Italy

Cite This Article

Alessandro De Cassai, Federico Geraldini, Serkan Tulgar, et al. (2022). Opioid-free anesthesia in oncologic surgery: the rules of the game. Journal of Anesthesia, Analgesia and Critical Care, 2(1). https://doi.org/10.1186/s44158-022-00037-8

Opioid-free anesthesia in oncologic surgery: the rules of the game

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