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Abstract Suggests that increased total dose of opioids during cardiac surgery may lead to increased in-hospital, as well as long-term post-operative pain medication requirements for up to one year (5). Moreover, according to Hirji et al study , ongoing opioid use three monthsafter CABG was present in 21.7% of opioidexposed patients versus 3.2% of opioid-naive patients (6). In addition, Opioids have many known side effects such as somnolence, brainstemand respiratory depression , and chronic opioid dependence (7–9), and there is a national trendto decrease opioid use during non-cardiac surgery to promote faster recovery and decrease narcotic use post-operatively (1) . Several studies demonstrated the effectiveness of Opioid-free Anesthesia (OFA) in patients undergoing non-cardiac surgery(4,10,11). Preoperative use of COX inhibitors, GABA analogues and acetaminophen have been shown to decrease use of opioids postoperatively(10).Intraoperative use of agents that lead to opioid sparing effects via sodium channel blockade, blockade of G proteincoupled receptors, NMDA blockade |