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Propofol + rocuronium + remifentanil + fentanyl is a multi-drug anesthetic combination used as a conventional opioid-based anesthesia protocol. This specific regimen was employed as the control arm in clinical trials conducted by the University Hospital, Basel, to evaluate nociception levels during surgery. The combination provides a comprehensive anesthetic state: propofol acts as a hypnotic agent via GABA-A receptor modulation; rocuronium provides neuromuscular blockade by antagonizing nicotinic acetylcholine receptors; and the synthetic opioids fentanyl and remifentanil provide potent analgesia through mu-opioid receptor activation. This protocol is typically administered intravenously to patients undergoing procedures such as laparoscopic surgery to ensure hypnosis, muscle relaxation, and pain control.
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