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 were scheduled 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 bispectral index and 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 awakening 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