Opioid-free anesthesia in enhanced recovery after supratentorial craniotomies: a case series

Enhanced Recovery After Surgery (ERAS) is a recovery method developed to minimize pain and improve post-operative healing in patients. Brain tumor resection using the ERAS concept is relatively new. This case series evaluates the implementation of the ERAS protocol in three female patients diagnosed with supratentorial brain tumors. All patients presented with headache as a primary symptom and underwent craniotomy under general anesthesia supplemented with a scalp block. The surgeries were performed with stable hemodynamics, and anesthesia was maintained using dexmedetomidine, propofol, and rocuronium. After surgery, the patients were immediately extubated and treated in the intensive care unit. The use of opioid-free anesthesia significantly supported the ERAS principles by reducing pain, postoperative nausea and vomiting (PONV), and shivering. This case series highlights the potential of opioid-free anesthesia as an effective alternative to opioids, aligning with the ERAS protocols to improve postoperative outcomes in brain tumor resection.