الفهرس 
Pharmacology of DexmedetomidineOnly 14 pages are availabe for public view
 |  | from | 94 |  |  |
| | | from | 94 | | |
Abstract
Obesity is a significant health problem with clearly established health implications, including an increased risk for hypertension, coronary artery disease, obstructive sleep apnea, diabetes mellitus, dyslipidemia, degenerative joint disease, gallbladder disease, psychosocial impairment and pulmonary problems that may get worse under general anesthesia.
Opioids are widely used for perioperative pain relief. However, there have an increasing number of undesirable side effects such as respiratory depression, nausea, vomiting, constipation, dizziness, pruritus, and dry mouth that can lead to significant morbidity and mortality particularly in morbidly obese patients. Furthermore, short-acting opioids used during anesthesia may lead to acute opioid induced tolerance and hyperalgesia.
Opioid-free Anesthesia (OFA) is a technique in which no intraoperative neuraxial, systemic or intracavitary opioid is used but instead adjuvant agents are administrated for their opioid sparing effect. General anesthesia aims to provide analgesia, amnesia, control of autonomic effects and rapid emergence. A stress free anesthetic is required and the availability of opioids was the ideal agents to achieve these needs in the past.
The use of nonopioid analgesics after opioid-free anesthesia has been found to be effective for postoperative pain. With minimally invasive surgical techniques, surgical trauma can be minimized and the use of anti-inflammatory agents can improve quality of recovery and decrease postoperative pain. Nonopioid analgesics like NSAIDs and paracetamol are often employed perioperatively. Additionally low-dose dexmedetomidine can also be used. Similarly lidocaine can also be employed to improve the autonomic block as well as postoperative analgesia.
This study was conducted to compare the effectiveness of opioid-free anesthesia versus opioid based general anesthesia on sixty morbidly obese patients BMI ≥ 40 Kg/m2, ASA III, their ages ranged from 20-60 years old undergoing laparoscopic cholecystectomy under general anesthesia.