lidocaine + ketamine + dexamethasone + esmolol

The lidocaine + ketamine + dexamethasone + esmolol regimen, often referred to as the OFACAR regimen, is a non-opioid balanced general anesthesia protocol developed by the Centre Hospitalier Universitaire Dijon. It is specifically designed for use in adult patients undergoing cardiac surgery with extracorporeal circulation. The regimen utilizes lidocaine for its analgesic and anti-inflammatory properties, ketamine for NMDA-mediated analgesia and prevention of hyperalgesia, dexamethasone to reduce the systemic inflammatory response and postoperative nausea, and esmolol to manage heart rate and sympathetic outflow. By eliminating opioids from the anesthetic plan, the regimen aims to reduce the incidence of opioid-related adverse events such as postoperative respiratory depression, ileus, and nausea, potentially accelerating recovery and shortening hospital stays. This combination was evaluated against standard morphine-based anesthesia in the Phase 3 OFACAR trial.

Other names

Opioid-free anesthesia regimenOFA regimendexamethasone-Centre Hospitalier Universitaire Dijon-cardiac surgery