Background: The multimodal analgesic drugs act at all four levels of pain pathway, as it having synergistic effects, it is effective in preventing and treating acute pain. Methods: This is prospective, double blind, randomized clinical trial involving 42 patients belonging to the American Society of Anaesthesiologists Class I and II scheduled to undergo elective lumbar spine surgery were allocated into two groups of 21 each. Group A (study group) received injection diclofenac sodium, paracetamol, clonidine, and skin infiltration with bupivacaine adrenaline and Group B (control group) received paracetamol and skin infiltration with saline adrenaline. Pre-emptive analgesia was practiced in both the groups. BIS guided induction was done with incremental doses of Inj propofol. Two 2 ml blood samples were drawn; one just before tracheal tube placement and another one 3. Conclusion: Pre-emptive MMA when judiciously administered targeting all the four elements of the pain pathway reduce consumption of anaesthetic drugs and provided optimal surgical conditionsby ensuring intense analgesia with minimal adverse effects.0 min following skin incision for random serum cortisol and random blood sugar.