Hemodynamic control during craniotomies can be a bit hectic specially during periods of
intense noxious stimulation. For long anesthesiologists used high doses of opioids such as
fentanyl and remifentanyl to provide analgesia with a good hemodynamic control during
intraoperative period in patients undergoing craniotomies. However, the use of opioids was
not devoid of side effects. Exploring other anesthetic plans using multiple opioid free
anesthetic adjuvants that have analgesic effects given together in small doses appear to be
appealing plan. This idea is the basis of our proposed study in which we compare the
hemodynamic effects of using opioid free anesthesia versus opioid anesthesia in cranial
surgeries.