[Laparotomy in a patient under opioid free anesthesia]

Area of Science:

• Anesthesiology
• Bariatric Surgery
• Pain Management

Background:

• Obesity increases surgical risks, often managed with opioids.
• Opioid-free anesthesia (OFA) aims to mitigate opioid-related complications in bariatric surgery.
• A potential drawback of OFA is the risk of converting laparoscopic to open surgery due to inadequate sympathetic or nociceptive control.

Observation:

• A patient undergoing laparoscopic bariatric surgery was maintained on OFA.
• The surgical approach was converted to open surgery (exploratory laparoscopy).

Findings:

• Opioid-free anesthesia provided effective hemodynamic control during the conversion to open surgery.
• Perioperative pain was successfully managed without opioids throughout the procedure.

Implications:

• This case demonstrates the feasibility of OFA even in complex surgical conversions.
• OFA can be a viable anesthetic strategy for bariatric surgery, including cases requiring conversion to open procedures.
• Further research into OFA's role in managing surgical stress and pain is warranted.