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This multimodal analgesia regimen was developed and studied by Udayana University for the management of acute postoperative pain, specifically in patients undergoing elective hysterectomy. The regimen is designed to target multiple pain and inflammatory pathways to reduce peripheral and central sensitization, thereby preventing the transition from acute to chronic postoperative pain. It consists of a combination of several pharmacological agents: morphine (an opioid agonist administered via patient-controlled analgesia), bupivacaine (a local anesthetic sodium channel blocker), dexmedetomidine (an alpha-2 adrenergic agonist), etoricoxib (a selective COX-2 inhibitor), and paracetamol (a non-opioid analgesic). The protocol utilizes various routes of administration, including intravenous, epidural, and oral, to optimize analgesic efficacy and modulate inflammatory biomarkers such as MCP-1, BDNF, and microRNA-124.
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