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acetaminophen + ketorolac + magnesium sulfate + dexmedetomidine + lidocaine + ketamine
- Development stage
- Phase 1
- Lead developer
- Kasr Al Ainy Hospital
- Modality
- Small Molecules
- Administration
- Intravenous
01
Overview
This multimodal analgesic regimen is an opioid-free anesthesia (OFA) protocol developed and evaluated by Kasr El Aini Hospital for adult patients undergoing craniotomies for supratentorial neoplasms. The regimen is designed to provide stable intraoperative hemodynamics and effective analgesia without the side effects typically associated with high-dose opioids, such as respiratory depression and postoperative nausea. It consists of a combination of six agents: acetaminophen and ketorolac for non-opioid systemic analgesia; magnesium sulfate and ketamine as NMDA receptor antagonists to prevent central sensitization; dexmedetomidine as an alpha-2 adrenergic agonist for sedation and sympatholysis; and lidocaine as a systemic sodium channel blocker. This combination targets multiple pain pathways simultaneously to achieve a synergistic anesthetic effect.
- Other names
- Opioid-free anesthesia regimenOFA regimen
02
Targets
PGHS-1 (Prostaglandin G/H Synthase 1)PTGS2 (Prostaglandin-Endoperoxide Synthase 2)COX-2 (Prostaglandin G/H synthase 2)ADRA2A (α2A)NMDAR (Glutamate receptor ionotropic, NMDA)NaV (Voltage-gated sodium channels)CaV (Voltage-gated calcium channel protein complex)
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