Dexmedetomidine-based Total Endovenous Anesthesia in Radical Surgery for Breast Cancer. An observational case series study involving 10 patients

Introduction: Ambulatory treatment of breast cancer is limited by vomiting and post-operative pain, and general anesthesia is implicated in these effects. Dexmedetomidine supplies analgesia and sedation without respiratory depression when it is administered intravenously. We demonstrate the usefulness of Dexmedetomidine as a general endovenous anesthesia. Methods: Female patients were included with ages ranging between 42 and 83 years old and with a breast cancer diagnosis. They werescheduled for radical surgery between May 2009 and April 2011. Dexmedetomidine plus Propofol and Fentanyl were administered. Intra-operative monitoring included electrocardiography, arterial blood gas analysis, blood pressure, heart rate, respiratory rate, and arterial oxygen saturation. We registered surgery and sedation according to the bispectralindexand Ramsay scales. Results: The patients were maintained with 95% oxygen saturation and breathed spontaneously during the entire procedure with supplementary oxygen.Their blood pressure remained constant;heart rate showed only a mild reduction, bispectral index was maintained at 50, and the Ramsey scale-at IV. The infusion was discontinued without the patients experiencing dizziness or vomiting; the patients had an easy response-to-voice a wakening and remained in the recovery room for at least 2 h. They were physiologically stable, and were left with additional supplementary oxygen. There was no pain or agitation observed during the recovery period and no narcotic was administered. Conclusion: Dexmedetomidine is a useful intravenous anesthetic agent in procedures such as radical breast surgery, with faster recovery and residual analgesia.