Multimodal Technique to Maximize Perioperative Pain Control and Minimize Opioid Use in a Patient Undergoing Laparoscopic Cholecystectomy: A Case Report

Perioperative opioid sparing techniques are paramount given the current opioid epidemic. A 54-year-old woman presented with medical history of acute cholecystitis for laparoscopic cholecystectomy. Our goal was adequate pain control while limiting opioid administration and opioid-related adverse effects. Pain was managed with preoperative acetaminophen, tramadol, and gabapentin, and intraoperatively with lidocaine, ketamine, and esmolol. Post-operative Visual Analog Score (VAS) was 0/10 immediately following surgery. Although her pain score peaked to 10/10 30 minutes post-operatively and she received 0.4 milligrams intravenous hydromorphone, her VAS then declined to 0 and remained so throughout her hospitalization without additional analgesics.