Opioid-Free Anesthesia

Opioid-free anesthesia (OFA) is a multimodal anesthetic technique that eliminates the use of intraoperative opioids, aiming to reduce associated side effects such as postoperative nausea and vomiting (PONV), respiratory depression, and hyperalgesia. The specific protocol evaluated by Muhammad Rahman Efendi Nasution for patients undergoing elective abdominal surgery involves a combination of several non-opioid agents: dexmedetomidine (an alpha-2 adrenergic agonist for sedation and sympatholysis), low-dose ketamine and magnesium sulfate (NMDA receptor antagonists for analgesia and prevention of central sensitization), intravenous lidocaine (a sodium channel blocker with systemic analgesic and anti-inflammatory properties), and a combination of acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) for central and peripheral cyclooxygenase (COX) inhibition. Clinical trial results indicate that this OFA regimen provides intraoperative nociceptive control comparable to traditional opioid-based anesthesia (as measured by the qNOX index) while significantly improving postoperative outcomes by reducing the incidence of PONV.

Other names

OFANon-Opioid AnalgesicsOpioid-Free Anesthesia ProtocolMultimodal Non-Opioid Regimen