Penggunaan Opioid-Free Anaesthesia (OFA): Laporan Kasus
DOI:
https://doi.org/10.35790/msj.v5i1.47644Abstract
Perioperative use of opioids has many detrimental effects on health care outcomes and is currently accelerating the worldwide epidemic of opioid addiction prescription and overdose death. Due to the excessive use of opioids and their side effects, a new strategy was developed in order to achieve a balanced general anesthesia, namely opioid-free anesthesia (OFA). This technic can be used in most surgeries using alternative analgesic drugs. We reported a female patient, 59 years old, referred to the Department of Anesthesia from the Department of Surgery for elective thyroidectomy. The patient was diagnosed as ASA 3, Actual: difficult airway, subclinical hyperthyroidism, drug allergy, controlled hypertension (with amlodipine 10 mg); Potential: difficult intubation. We used general anasethesia with endotracheal tube, premedication with midazolam 2 mg iv, analgesic with dexme-detomidine 0.1 mcg /kg BW worn out in 10 minutes. The operation went smoothly and on the 2nd day after surgery, the patient was transferred to the regular ward. In conclusion, the use of non-opioid anesthetic drugs is an effective and rational choice in order to reduce the side effects of postoperative opioids in this patient.
Keywords: anesthesia; opioid-free; hyperthyroid
Abstrak: Penggunaan opioid perioperatif memiliki banyak efek merugikan pada hasil perawatan kesehatan dan saat ini mempercepat epidemi kecanduan peresepan opioid dan kematian akibat overdosis di seluruh dunia. Oleh karena penggunaan opioid yang berlebihan dan efek sampingnya, maka dikembangkanlah suatu strategi baru dalam rangka mencapai anestesi umum yang seimbang yaitu opioid-free anaesthesia (OFA). Teknik ini dapat digunakan pada sebagian besar operasi dengan memakai obat analgesik alternatif. Kami melaporkan seorang pasien perempuan, 59 tahun, dirujuk ke Bagian Anestesi dari Bagian Bedah untuk operasi elektif tiroidektomi. Diagnosis pasien ini ialah ASA 3, Aktual: difficult airway, hipertiroid subklinis, alergi obat, hiperetensi terkontrol (amlodipin 10 mg); Potensial: sulit intubasi. Teknik anestesi ialah general anaesthesia (GA) dengan endotracheal tube (ETT), dengan premedikasi midazolam 2 mg iv, analgetik dexmedetomidine 0,1 mcg/kg BB habis dalam 10 menit. Operasi berjalan lancar dan pada hari kedua pasca bedah, pasien dipindahkan ke ruang rawat biasa. Simpulan studi ini ialah penggunaan obat anestesi non-opiod merupakan pilihan yang efektif dan rasional dalam rangka mengurangi efek samping opioid paska operasi pada pasien ini.
Kata kunci: anestesi; bebas opioid; hipertiroid
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