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remifentanil + morphine + desflurane
- Development stage
- Unknown
- Lead developer
- Centre Hospitalier Universitaire de Clermont-Ferrand
- Modality
- Small Molecules
- Administration
- Intravenous, Inhalation
01
Overview
This anesthetic and analgesic regimen consists of the intraoperative administration of **remifentanil**, **morphine**, and **desflurane**, specifically titrated using the **Analgesia/Nociception Index (ANI)**. Developed and studied by the **University Hospital, Clermont-Ferrand** in the GOALDAN clinical trial, the protocol aims to optimize perioperative analgesia and reduce immediate postoperative pain. Remifentanil is used for continuous intraoperative analgesia, while morphine is administered prophylactically at the end of the surgical intervention based on nociception levels determined by the ANI monitor. Desflurane is utilized for the maintenance of general anesthesia at the lowest effective minimal alveolar concentration (MAC). The ANI monitor provides a non-invasive assessment of the autonomic nervous system via heart rate variability to guide opioid dosing, aiming to balance nociception and antinociception during surgery.
- Brand names
- UltivaSuprane
- Other names
- ANI-guided analgesiaGOALDAN protocolANI-guided anesthetic regimen
02
Targets
GABRR (GABA-A receptor subunit rho)NMDAR (Glutamate receptor ionotropic, NMDA)MOR (Mu opioid receptor)
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