Friedberg’s Triad is a concept introduced by Dr. Barry Friedberg, an anesthesiologist, that aims to provide opioid-free anesthesia and better outcomes for patients. The triad consists of three components: measuring the brain, preempting the pain, and abstaining from emetic drugs. The idea behind this approach is to use the patient’s brain activity as a guide to determine the appropriate amount of anesthesia required, thereby reducing the need for opioids. This approach has been gaining popularity in recent years, especially in places where opioid-free anesthesia is preferred.
Opioid-free anesthesia (OFA) is a type of anesthesia that does not use opioids to manage pain during surgery. Instead, it uses other medications and techniques to reduce pain and discomfort. The goal of OFA is to provide a safer alternative to traditional anesthesia that would provide benefits as well as enhance recovery after surgery. Traditional anesthesia, on the other hand, often relies on opioids to relieve pain. Opioids are a class of drugs that are used to manage pain but can cause side effects such as nausea, vomiting, and respiratory depression. While opioids are effective in managing pain, they can also be addictive and lead to dependence. According to a study published in the Neurosurgical Focus journal, OFA within an enhanced recovery after surgery (ERAS) pathway for lumbar spinal decompression represents an opportunity to minimize perioperative opioid exposure without adversely affecting pain control or recovery. The study found that there was a significant reduction in total perioperative opioid consumption in patients who received OFA, compared to patients who received traditional opioid-containing anesthesia (OCA). There were no significant differences in worst postoperative pain scores or opioid consumption in the postanesthesia care unit (PACU) between OFA and OCA groups, respectively. However, there was a clinically significant decrease in time to readiness for discharge from the PACU associated with OFA.
In general, OFA can enhance recovery after surgery by reducing the risk of opioid-related side effects such as nausea, vomiting, and respiratory depression, which can delay recovery 1234. Additionally, OFA can help patients avoid opioid dependence and addiction, which can be a serious concern.
There are several techniques used in OFA to manage pain. Here are some of them:
Physical therapy: Physical therapy involves physical techniques to strengthen and stretch the muscles and joints. It can relieve pain throughout the body, while the specific methods will vary by body part. Therapeutic exercise can have long-term benefits for chronic pain, including helping people cope.
Hot and cold therapy: Hot and cold therapy is a common and safe technique to reduce pain. Heat can help relax the muscles and dilate the blood vessels. It can also promote healing after an injury. Cold therapy reduces blood flow and reduces inflammation that causes pain. It often involves applying an ice pack wrapped in a towel to the skin.
Massage: Massage is a type of soft-tissue manipulation. People may benefit from this technique when used with other pain management treatments, such as physical therapy and pain medication. The benefits of massage include relaxation, increased flexibility, reduced inflammation, improved posture, improved circulation, and reduced stiffness.
Acupuncture: Acupuncture involves a practitioner applying thin needles to the skin at precise points in the body. It is believed to stimulate the body’s natural painkillers and improve blood flow.
Cognitive-behavioral therapy (CBT): CBT is a type of talk therapy that helps people change negative thought patterns and behaviors. It can help people with chronic pain learn how to manage their pain and improve their quality of life.
Feedback
Comparing opioid free general anesthesia to traditional balanced ...
https://asja.springeropen.com/articles/10.1186/s42077-022-00218-1
Opioid-free anesthesia (OFA) is a type of anesthesia that does not use opioids to manage pain during surgery. Instead, it uses other medications and techniques to reduce pain and discomfort 1234. The goal of OFA is to provide a safer alternative to traditional anesthesia that would provide benefits as well as enhance recovery after surgery.
According to a study published in the Neurosurgical Focus journal, OFA within an enhanced recovery after surgery (ERAS) pathway for lumbar spinal decompression represents an opportunity to minimize perioperative opioid exposure without adversely affecting pain control or recovery. The study found that there was a significant reduction in total perioperative opioid consumption in patients who received OFA, compared to patients who received traditional opioid-containing anesthesia (OCA). There were no significant differences in worst postoperative pain scores or opioid consumption in the post-anesthesia care unit (PACU) between OFA and OCA groups, respectively. However, there was a clinically significant decrease in time to readiness for discharge from the PACU associated with OFA.
In general, OFA can enhance recovery after surgery by reducing the risk of opioid-related side effects such as nausea, vomiting, and respiratory depression, which can delay recovery 1234. Additionally, OFA can help patients avoid opioid dependence and addiction, which can be a serious concern.
Opioid-free anesthesia (OFA) is a type of anesthesia that does not use opioids to manage pain during surgery. Instead, it uses other medications and techniques to reduce pain and discomfort. The goal of OFA is to provide a safer alternative to traditional anesthesia that would provide benefits as well as enhance recovery after surgery.
There are several techniques used in OFA to manage pain. Here are some of them:
Physical therapy: Physical therapy involves physical techniques to strengthen and stretch the muscles and joints. It can relieve pain throughout the body, while the specific methods will vary by body part. Therapeutic exercise can have long-term benefits for chronic pain, including helping people cope.
Hot and cold therapy: Hot and cold therapy is a common and safe technique to reduce pain. Heat can help relax the muscles and dilate the blood vessels. It can also promote healing after an injury. Cold therapy reduces blood flow and reduces inflammation that causes pain. It often involves applying an ice pack wrapped in a towel to the skin.
Massage: Massage is a type of soft-tissue manipulation. People may benefit from this technique when used with other pain management treatments, such as physical therapy and pain medication. The benefits of massage include relaxation, increased flexibility, reduced inflammation, improved posture, improved circulation, and reduced stiffness.
Acupuncture: Acupuncture involves a practitioner applying thin needles to the skin at precise points in the body. It is believed to stimulate the body’s natural painkillers and improve blood flow.
Cognitive-behavioral therapy (CBT): CBT is a type of talk therapy that helps people change negative thought patterns and behaviors. It can help people with chronic pain learn how to manage their pain and improve their quality of life.
Developments in Opioid-Free Anesthesia