Opioid-free total intravenous anesthesia for valvular cardiac replacement surgery

Muhammad  Rizqhan; Aryasena  Andhika Wiedjaja

Authors

Muhammad Rizqhan National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Aryasena Andhika Wiedjaja Faculty of Medicine, Pelita Harapan University, Banten, Indonesia

Keywords:

Cardiopulmonary bypass, mitral valve replacement, opioid free total intravenous anesthesia, rheumatic heart disease, tricuspid valve repair

Abstract

A 44-year-old woman with rheumatic heart disease with severe mitral stenosis, moderate–severe mitral regurgitation, and severe tricuspid regurgitation underwent mitral valve replacement and tricuspid repair under cardiopulmonary bypass using opioid-free total intravenous anesthesia (OF-TIVA) with propofol, ketamine, lidocaine, and dexmedetomidine, combined with a transversus thoracic plane (TTP) block. The patient’s intraoperative hemodynamics remained stable, and the patient was extubated six hours postoperatively with minimal pain and no complications. OF-TIVA with TTP block provided effective analgesia, hemodynamic stability, and early recovery, thus highlighting its potential as a safe alternative to opioid-based anesthesia in cardiac valve surgery.

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