Evaluation of the efficacy of dexmedetomidine infusion on the quality of balanced anesthesia and postmastectomy pain

BackgroundThe authors studied the effect of intraoperative infusion of dexmedetomidine on the quality of anesthesia, anesthetic requirements in patients undergoing radical mastectomy, and its effect on acute and chronic postmastectomy pain.Patients and methodsA total of 76 female patients undergoing radical mastectomy were randomly classified into two groups: group I received intraoperative dexmedetomidine infusion and group II, the control group, received an infusion of normal saline. Heart rate, mean arterial blood pressure, end tidal isoflurane concentration, amount of fentanyl and muscle relaxant increments, recovery characteristics, quality of postoperative analgesia for 3 days, and incidence of side effects were recorded. Incidence of chronic pain was reported after 6 months.ResultsThere was a significant decrease in mean arterial blood pressure and heart rate in group I from 1 min after skin incision and onwards. Extubation time and response to verbal command were significantly shorter in the dexmedetomidine group than in the control group (P = 0.003 and P < 0.0001, respectively), and end tidal concentration of isoflurane was significantly lower in group I (P < 0.0001). There was a significant decrease in fentanyl requirement in the operating room in group I (P < 0.0001). Time to first analgesia was significantly longer in group I (P < 0.0001). There was a significant decrease in postoperative analgesic requirement and a better quality of analgesia in the dexmedetomidine group (P < 0.0001). Pain scores at 6 months were comparable in both groups.ConclusionThis study showed that the use of intravenous dexmedetomidine had a sparing effect on anesthetic and analgesic requirements with hemodynamic stability effect and no protective effect from the development of chronic pain.