Abstract
Acute postoperative pain following radical mastectomy is a high risk for prolonged convalescence and potential persistent pain in patients with breast cancer. The present study was designed to observe the effect of intraoperative use of dexmedetomidine on acute postoperative pain following radical mastectomy under general anesthesia. Forty-five patients were enrolled into the study and divided into two groups that were maintained with propofol/remifentanil/Ringer's solution or propofol/remifentanil/Dexmedetomidine followed by morphine-based patient-controlled analgesia. During the first 24 h following surgery, patients receiving dexmedetomine had lower NRS pain scores, decreased morphine consumption, longer time to first morphine request as well as a trending decreased incidence of adverse effects when compared to those received Ringer's solution. In conclusion, the present study finds that intraoperative use of dexmedetomidine could promote analgesic property of postoperative morphine.
Highlights
A total of 48 patients scheduled for radical mastectomy under general anesthesia were assessed for eligibility
45 patients were enrolled in this clinical observation trail and randomized into two groups: R group (21 patients) and D group (24 patients), which received either propofol/remifentanil and Ringer’s solution or dexmedetomidine (Figure 1)
Patients from the two groups were comparable with respect to age, weight, height, Body mass index (BMI), American Society of Anesthesiologists (ASA) class, operation time, anesthesia time, and post-anesthesia care unit (PACU) time (Table 1)
Summary
A large number of patients underwent radial mastectomy for management of breast cancer experience acute postoperative pain, which leads to prolonged convalescence and additional hospital costs and needs rapid treatment (Jain et al, 2012; Mohamed et al, 2014; Mohta et al, 2016). Recent clinical trials have found that both intraoperative and postoperative use of dexmedetomidine, a highly selective alpha-2 adrenergic agonist, could facilitate the analgesic property of PCA morphine, reduce morphine consumption as well as its related adverse effects in different types of surgeries, including abdominal surgeries, radical mastectomy, and multi-fracture surgery (Jain et al, 2012; Mohamed et al, 2014; Ge et al, 2015a,b, 2016; Ren et al, 2015; Li et al, 2016; Mohta et al, 2016; Su et al, 2016; Wang et al, 2016; Zhao et al, 2016). We hypothesized that intraoperative use of dexmedetomidine might promote analgesic effect of PCA morphine, and reduce morphine consumption
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