Outcome of Multimodal Anesthesia Bern

Insel Gruppe AG, University Hospital Bern

Status: Completed

Conditions: Postoperative Complications; Pain, Postoperative; Opioid Use; Postoperative Nausea

Treatments: Procedure: General anesthesia using conventional opioid-based regimen; Procedure: General anesthesia applying multimodal anesthesia

Study type: Interventional

Funder types: Other

Identifiers

NCT06985069

2025-00283 (Other Identifier)

MMA 25-01

Details and patient eligibility

About

In the context of the ongoing opioid crisis in the USA and Europe, reducing perioperative opioid use is a growing priority. Multimodal anesthesia (MMA) offers a patient-centered alternative to opioid-free anesthesia, combining regional techniques, non-opioid analgesics, and adjunct therapies to enhance pain control while minimizing opioid reliance. By targeting multiple pain pathways, MMA can improve recovery outcomes, reduce side effects, and optimize resource use, representing a potential paradigm shift in perioperative medicine.

This study compares (patient-centered) outcomes after application of MMA (a standardized combination of Magnesium, Ketamine, Lidocain and Dexmedetomidine before and during surgery in combination with opioids) with an opioid based general anesthesia regimen in the context of major surgery.

Enrollment: 240 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Existing informed consent
• German, Italian or French speaking
• Age 18 or more
• Planned duration of surgery 60min or more
• Inpatients and postoperative transfer to PACU or 24h ICU

Exclusion criteria

• Palliative or emergency procedures
• Reoperation (e.g. 2nd look)
• Bariatric surgery patients
• Pregnancy / breastfeeding
• Adults legally protected
• Known allergy or contraindication to interventional medication

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

240 participants in 2 patient groups

Multimodal anesthesia-group

Experimental group

Description:

The intervention consists of the application of a standardized combination of Magnesium, Ketamine, Lidocaine and Dexmedetomidine before and during surgery in combination with opioids (Fentanyl, Methadone, and Hydromorphon) in a non-standardized fashion for perioperative pain control.

Treatment:

Procedure: General anesthesia applying multimodal anesthesia

Opioid based-group

Active Comparator group

Description:

Patients in the control group will be treated with opioids only (Fentanyl, Methadone, Hydromorphone) at the discretion of the treating anesthetist for perioperative pain control.

Treatment:

Procedure: General anesthesia using conventional opioid-based regimen