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Dexmedetomidine + ketamine + lidocaine is a multimodal analgesic combination therapy being evaluated by the National Taiwan University Hospital. This combination leverages the synergistic effects of three distinct pharmacological agents: dexmedetomidine (a highly selective alpha-2 adrenergic agonist), ketamine (an N-methyl-D-aspartate [NMDA] receptor antagonist), and lidocaine (a local anesthetic and systemic sodium channel blocker). The mixture is primarily investigated for its anesthetic-sparing effects and its potential to provide renal protection (reducing the risk of acute kidney injury) in patients undergoing complex procedures such as head and neck cancer surgery with free flap microvascular reconstruction. By targeting multiple pain pathways and reducing the systemic inflammatory response, the combination aims to improve postoperative outcomes and reduce the reliance on high-dose volatile anesthetics and opioids.
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