الفهرس 
Multimodal Opioid-free Anesthesia versus Opioid-based Anesthesia for Patients undergoing Cardiac Valve Surgeries: A Randomized Controlled Trial
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Abstract
Suggests that increased total dose of opioids during cardiac surgery may lead to
increased in-hospital, as well as long-term post-operative pain medication
requirements for up to one year (5). Moreover, according to Hirji et al study ,
ongoing opioid use three monthsafter CABG was present in 21.7% of opioidexposed patients versus 3.2% of opioid-naive patients (6). In addition, Opioids
have many known side effects such as somnolence, brainstemand respiratory
depression , and chronic opioid dependence (7–9), and there is a national trendto
decrease opioid use during non-cardiac surgery to promote faster recovery and
decrease narcotic use post-operatively (1) .
Several studies demonstrated the effectiveness of Opioid-free Anesthesia
(OFA) in patients undergoing non-cardiac surgery(4,10,11).
Preoperative use of COX inhibitors, GABA analogues and
acetaminophen have been shown to decrease use of opioids
postoperatively(10).Intraoperative use of agents that lead to opioid
sparing effects via sodium channel blockade, blockade of G proteincoupled receptors, NMDA blockade