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Ketamine + lidocaine + magnesium sulfate is an investigational combination therapy regimen being studied by researchers at Ain Shams University for use in opioid-free anesthesia (OFA). The protocol involves the intravenous infusion of these three agents to manage intraoperative bleeding and improve the quality of the surgical field during endoscopic nasal surgeries. Ketamine acts as an NMDA receptor antagonist, providing potent analgesia and maintaining hemodynamic stability. Lidocaine, a sodium channel blocker, offers systemic anti-inflammatory and analgesic effects. Magnesium sulfate functions as both an NMDA receptor antagonist and a calcium channel modulator, which helps in achieving controlled hypotension and reducing the requirement for volatile anesthetics. This triple-drug approach is designed to optimize surgical conditions while avoiding the side effects associated with traditional opioid-based anesthetic techniques.
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