A Challenging Cesarean Delivery and Perioperative Course in a Former Polysubstance Abuser Without the Use of Traditional Opioids

David A. Gutman, Jennifer R. Matos, Christopher A. Skorke



Substance abuse is a major challenge in the United States. According to the Human Resources and Services Administration, we are in an opioid crisis with over 130 people a day dying from opioid-related drug overdoses. As awareness of this epidemic has grown, there has been an increase in patients coming in for surgery requesting a narcotic-free anesthetic. This presents both a challenge and an opportunity for the anesthesiologist who has a duty to respect the patient’s autonomy while simultaneously achieving the appropriate perioperative outcome. The considerations are especially important in the vulnerable population of pregnant women.

J Med Cases. 2020;11(3):65-67
doi: https://doi.org/10.14740/jmc3447



Polysubstance abuse; Patient autonomy; Regional anesthesia; Cesarean delivery; Relapse; Recovery; Opioid sparing; Buprenorphone; Medical ethics; Quadratus lumborum

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