Is an opioid-free anaesthesia possible without using alpha-2 agonists?

Opioid-free anaesthesia (OFA) is an anaesthetic technique where non-opioid drugs are used in the intraoperative period. It can be successful without using alpha-2 agonists, which are main drugs used in this multimodal anaesthesia. We are presenting seven different cases where OFA was used in different abdominal surgeries (laparoscopic cholecystectomy, colon cancer operation, and laparoscopic inguinal hernia repair) alone or in a combination with epidural anaesthesia and peripheral nerve block. Prior induction to general anaesthesia all patients received dexamethasone and paracetamol. Induction of general anaesthesia consisted of giving midazolam, lignocaine, propofol, ketamine, and rocuronium. After tracheal intubation anaesthesia was maintained with sevoflurane and continuous infusion with lignocaine, magnesium sulphate, and ketamine (in some patients). At the end of the surgery, all patients received metamizole. The postoperative pain scores were reduced in most of the patients without giving opioids.