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Perioperative Challenges of Heroin Addiction: A Case Report of Opioid-Free Anesthesia in Tongue Carcinoma Excision With Free-Flap Reconstruction

2023-06Journal article Open access
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dc.contributor.authorAmeiro, Roberto J
dc.contributor.authorNeves, Sara
dc.contributor.authorOliveira, Rita P
dc.contributor.authorMarques, Beatriz B
dc.contributor.authorFerreira, Paulo-Roberto C
dc.date.accessioned2024-06-17T11:48:51Z
dc.date.available2024-06-17T11:48:51Z
dc.date.issued2023-06
dc.description.abstractAnesthesia for major head and neck surgery is historically heavily reliant on opioids with deleterious consequences. We reported a case of a patient with a history of heroin abuse submitted to a tongue carcinoma excision, followed by free-flap reconstruction under opioid-free anesthesia. We used a propofol total intravenous anesthesia and perfusions of ketamine, dexmedetomidine, lidocaine, and magnesium sulfate for analgesia, complemented by boluses of dexamethasone, acetaminophen, parecoxib, and metamizole. Hemodynamic needs of the procedure were addressed by titrating perfusions of sodium nitroprusside or dobutamine. The patient was weaned from the ventilator at the end of the surgery. Surgical outcomes were achieved and opioid-free analgesia allowed early reestablishment of bodily functions without compromise of adequate pain control. Anesthesia protocols for free-flap surgery still lack scientific evidence, especially in the context of substance abuse: opioid-sparing approaches seem a viable option, which requires further studies and familiarity by health care professionalspt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAmeiro RJ, Neves SS, Oliveira RP, Marques BB, Ferreira PC. Perioperative Challenges of Heroin Addiction: A Case Report of Opioid-Free Anesthesia in Tongue Carcinoma Excision With Free-Flap Reconstruction. Cureus. 2023;15(6):e41195. doi:10.7759/cureus.41195pt_PT
dc.identifier.doi10.7759/cureus.41195pt_PT
dc.identifier.issn2168-8184
dc.identifier.urihttp://hdl.handle.net/10400.16/2922
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherCureus, Inc.pt_PT
dc.relation.publisherversionhttps://www.cureus.com/articles/157191-perioperative-challenges-of-heroin-addiction-a-case-report-of-opioid-free-anesthesia-in-tongue-carcinoma-excision-with-free-flap-reconstruction#!/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectfree flap reconstructionpt_PT
dc.subjectheroin abusept_PT
dc.subjectopioid abusept_PT
dc.subjectopioid-free analgesiapt_PT
dc.subjectperioperative pain managementpt_PT
dc.titlePerioperative Challenges of Heroin Addiction: A Case Report of Opioid-Free Anesthesia in Tongue Carcinoma Excision With Free-Flap Reconstructionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceUnited States of Americapt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPagee41195pt_PT
oaire.citation.titleCureuspt_PT
oaire.citation.volume15pt_PT
person.familyNameNeves
person.givenNameSara
person.identifier.orcid0000-0002-8723-5341
person.identifier.ridQ-6784-2018
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationc319e0ed-ab7f-4ec7-adda-3e187c317ae0
relation.isAuthorOfPublication.latestForDiscoveryc319e0ed-ab7f-4ec7-adda-3e187c317ae0

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