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This multimodal opioid-free anesthesia (OFA) protocol was developed and evaluated by GCS Ramsay Santé pour l'Enseignement et la Recherche for the management of postoperative pain in patients undergoing laparoscopic colectomy. The regimen is designed to eliminate the use of intraoperative opioids by combining several non-opioid pharmacological agents with distinct mechanisms of action. The protocol includes the inhalational anesthetic sevoflurane, continuous intravenous infusions of dexmedetomidine (an alpha-2 adrenergic agonist), lidocaine (a local anesthetic and sodium channel blocker), and ketamine (an NMDA receptor antagonist). It also incorporates bolus administration of the corticosteroid dexamethasone and preoperative doses of acetaminophen, the NSAID ketoprofen, and the non-opioid analgesic nefopam. A Phase 3 clinical trial (NCT05031234) evaluated this OFA regimen against a conventional opioid-sparing anesthesia (OSA) approach, concluding that the OFA protocol did not significantly reduce postoperative opioid consumption or pain scores compared to the standard of care.
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