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dexmedetomidine + magnesium sulfate + lidocaine + ketamine + gabapentin + dexamethasone + acetaminophen + esmolol + urapidil
- Development stage
- Unknown
- Lead developer
- Ankara City Hospital Bilkent
- Modality
- Small Molecules
- Administration
- Intravenous, Oral
01
Overview
This multimodal opioid-free anesthesia (OFA) protocol was developed and studied by Ankara City Hospital Bilkent for use in patients undergoing elective open-heart surgery with cardiopulmonary bypass. The protocol is designed to provide comprehensive perioperative analgesia and sympathetic control while mitigating the adverse effects associated with traditional opioid-based anesthesia, such as respiratory depression, postoperative delirium, and nausea. It employs a combination of several non-opioid agents with distinct mechanisms of action: dexmedetomidine (alpha-2 adrenergic agonist), magnesium sulfate (NMDA receptor antagonist), lidocaine (sodium channel blocker), ketamine (NMDA receptor antagonist), gabapentin (alpha-2-delta calcium channel ligand), dexamethasone (corticosteroid), acetaminophen (analgesic/antipyretic), esmolol (beta-1 selective blocker), and urapidil (alpha-1 antagonist and 5-HT1A agonist). This multimodal approach is often supplemented with regional anesthesia techniques, such as fascial plane blocks, to optimize postoperative recovery and patient satisfaction.
- Other names
- non OpioidsOpioid-Free Anesthesia ProtocolOFA ProtocolOpioid-Free Anesthesia
02
Targets
α2δ (Voltage-gated calcium channel alpha-2-delta subunit)ADRA2A (α2A)COXNeuraminidaseIR (Imidazoline receptor)ADRA1A (α1A)GR (Glucocorticoid receptor)ADRB1 (β1)NMDAR (Glutamate receptor ionotropic, NMDA)NaV (Voltage-gated sodium channels)
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