A Comparative Evaluation of Intravenous Dexmedetomidine and Fentanyl in Breast Cancer Surgery: A Prospective, Randomized, and Controlled Trial.

BACKGROUND AND AIM: Recent studies have advised narcotic less anaestheic techniques for breast cancer surgeries due to altered immune system by use of opioids. So we planned this study to compare the efficacy of dexmedtomidine with fentanyl in breast cancer surgery in terms of haemodynamic stability, anaesthetic sparing effects, recovery profile and postoperative analgesia. MATERIAL AND METHODS: In this randomized prospective controlled trial, a total of 60 female patients were randomly assigned into two groups. Patients in group F (n = 30) received a loading dose of fentanyl 2 µg/kg with maintenance dose of 0.5 µg/kg/h and in group D (n = 30) received dexmedetomidine 1 µg/kg as loading dose with maintenance dose of 0.25 µg/kg/h till the end of surgery. Hemodynamic parameters, desflurane requirement, recovery profile and postoperative analgesia were monitored and compared in both the groups. RESULTS: Mean HR was less in group D compared to group F intraoperatively, before and after extubation with a significant p value. The mean MAP was also lower in group D compared to group F at all the time points. MAC requirements were found lower in group D compared to group F with a significant P < 0.001. Cognitive recovery in the form of time to respond to verbal commands, time to extubation, time to orientation was early in dexmedetomidine group. CONCLUSION: Dexmedtomidine can be used as suitable alternative to fentanyl in breast cancer surgeries due to better hemodynamic stability, anaesthetic sparing effects and better recovery profile.