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Tengku Addi Saputra^*✉ , Iwan Fuadi , Iwan Abdul

1. Departement of Neuroanesthesiology and Critical Care, Medical Faculty Universitas Padjajaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia. 

Abstract

The posterior fossa contains the cerebellum, midbrain, pons, medulla, and cranial nerves. The Cerebello Pontine Angle (CPA) brain tumor accounts for 5-10%. There is interest in the use of Opioid Free Anesthesia (OFA) and opioid-free analgesics are used to be part of Enhanced Recovery After Surgery (ERAS) in the posterior fossa tumor craniotomy. The case series describes opioid-free craniotomies for CPA and cerebellar meningioma infratentorial tumors. All patient induction using, dexmedetomidine, propofol, lidocaine, rocuronium, and xylocaine 10% oropharyng spray and maintained using dexmedetomidine (0.2–0.8 mcg/kgbb/hour), propofol (25–150 mcg/kgbb/minute), intermittent rocuronium, and 50% oxygen: 50% air. The ICU patient received mechanical ventilation following surgery. OFA with dexmedetomidine eliminates opioid reliance in most conventional anesthetics, extubates ICU patients less than 24 hours of surgery, lowers the length of stay (LOS), and minimizes opioid side effects and rapid recovery. Anesthetic management using OFA can be carried out in fossa posterior tumor craniotomy, so the ERAS protocol can be implemented in this case series‎.

Keywords: Anesthesia management, Opioid Free Anesthesia (OFA), Perioperative, Posterior fossa tumor

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