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flurbiprofen axetil + fentanyl + midazolam is a combination sedation and analgesic regimen developed by Beijing Anzhen Hospital for use in patients undergoing pulsed-field ablation (PFA) for atrial fibrillation. This protocol, referred to as the Enhanced Analgesia Group (DS2) in the DEEP-PFA clinical trial, combines the non-steroidal anti-inflammatory drug (NSAID) flurbiprofen axetil, the potent opioid analgesic fentanyl, and the benzodiazepine sedative midazolam. Flurbiprofen axetil acts as a non-selective inhibitor of cyclooxygenase (COX-1 and COX-2) enzymes to reduce prostaglandin synthesis. Fentanyl is a highly potent mu-opioid receptor agonist providing rapid-onset analgesia. Midazolam acts as a positive allosteric modulator of the GABA-A receptor, providing sedation and anxiolysis. The combination is designed to provide deep sedation without the need for airway assistance during cardiac ablation procedures.
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