Opioid sparing anaesthesia using dexmedetomidine in a morbidly obese patient with mandibular tumor requiring free fibular graft reconstruction surgery

Karan Singla, Indu Sen, Sunil Gaba


A 45 year old male diagnosed as a case of Ameloblastoma mandible, requiring mandibular reconstruction with a Free Fibular Flap graft was planned under general anaesthesia (GA).

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Fawcett WJ, Jones CN. Bespoke intra-operative anaesthesia the end of the formulaic approach. Anaesthesia. 2018;73:1062.

Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesthesia Analgesia. 2014 Jan 1;118(1):85-113.

Frauenknecht J, Kirkham KR, Jacot-Guillarmod A, Albrecht E. Analgesic impact of intra-opertive opioids vs opioid- free anaesthesia: a systematic review and metaanalysis. Anaesthesia. 2019;74(5):651-62.

Albrecht E, Kirkham KR, Liu SS, Brull R. Peri-operative intravenous administration of magnesium sulphate and postoperative pain: a meta-analysis. Anaesthesia. 2013;68:79-90.

Gaszyński T, Jakubiak J, Machała W. Occurrence of residual relaxation in patients with severe obesity and its impact on the course of the postoperative period - evaluation of current practice. Anest Ratow. 2012;6:33-40.

Bakhamees HS, El-Halafawy YM, El-Kerdawy HM, Gouda NM, Altemyatt S. Effects of dexmedetomidine in morbidly obese patients undergoing laparoscopic gastric bypass. Middle East J Anesthesiol. 2007;19(3):537-51.

Hofer RE, Sprung J, Sarr MG, Wedel DJ. Anesthesia for a patient with morbid obesity using dexmedetomidine without narcotics. Can J Anaesth. 2005;52(2):176-80.

Gaszynski T, Gaszynska E, Szewczyk T. Dexmedetomidine for awake intubation and an opioid-free general anesthesia in a superobese patient with suspected difficult intubation. Drug Des Devel Ther. 2014;8:909-12.

Yang X, Li Z, Gao C, Liu R. Effect of dexmedetomidine on preventing agitation and delirium after microvascular free flap surgery: a randomized, double-blind, control study. J Oral Maxillofacial Surg. 2015;73(6):1065-72.

Nunes S, Berg L, Raittinen LP, Ahonen H, Laranne J, Lindgren L, et al. Deep sedation with dexmedetomidine in a porcine model does not compromise the viability of free microvascular flap as depicted by microdialysis and tissue oxygen tension. Anesth Analg. 2007;105:666-72.