Outcome of Multimodal Anesthesia Bern

Impact of Multimodal Versus Opioid-Only Anesthesia on Short Term Quality of Recovery After Major Surgery: A Randomized Prospective Single-Center Superiority Trial

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.

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