An Evidence-Based Opioid-Free Anesthetic Technique to Manage Perioperative and Periprocedural Pain

Philip G. Boysen; Marisa M. Pappas; Bryan Evans

doi:10.31486/toj.17.0072

Research ArticleOPIOID STEWARDSHIP

An Evidence-Based Opioid-Free Anesthetic Technique to Manage Perioperative and Periprocedural Pain

Philip G. Boysen, Marisa M. Pappas and Bryan Evans

Ochsner Journal June 2018, 18 (2) 121-125; DOI: https://doi.org/10.31486/toj.17.0072

Philip G. Boysen

Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LAThe University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA

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For correspondence: pboysen@ochsner.org

Marisa M. Pappas

Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA

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Bryan Evans

Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA

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Figure. The diagram shows the metabolism of lidocaine and the comparative potency of active metabolites.

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Table. Dose-Dependent Effects of Lidocaine
Plasma Level, μg/mL Effect
1-5 Analgesia
>5-10 Circumoral numbness
Tinnitus
Skeletal muscle twitching
Hypotension
Myocardial depression
>10-15 Unconsciousness
Seizures
>15-25 Apnea
Coma
>25 Cardiovascular collapse

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An Evidence-Based Opioid-Free Anesthetic Technique to Manage Perioperative and Periprocedural Pain

Philip G. Boysen, Marisa M. Pappas, Bryan Evans

Ochsner Journal Jun 2018, 18 (2) 121-125; DOI: 10.31486/toj.17.0072

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An Evidence-Based Opioid-Free Anesthetic Technique to Manage Perioperative and Periprocedural Pain

Philip G. Boysen, Marisa M. Pappas, Bryan Evans

Ochsner Journal Jun 2018, 18 (2) 121-125; DOI: 10.31486/toj.17.0072

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Keywords

Anesthesia
balanced anesthesia
dexmedetomidine
lidocaine
opioid-related disorders
perioperative care

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Plasma Level, μg/mL	Effect
1-5	Analgesia
>5-10	Circumoral numbness
	Tinnitus
	Skeletal muscle twitching
	Hypotension
	Myocardial depression
>10-15	Unconsciousness
	Seizures
>15-25	Apnea
	Coma
>25	Cardiovascular collapse