Postoperative Analgesia Impact of Narcotic Free Anesthesia

The Impact on Postoperative Pain of Substituting Opioids by Beta Blockers for Peroperative Hemodynamic Control in Patients Undergoing Mastectomy

The first hypothesis of the study is that substituting fentanyl by esmolol and metoprolol during general anesthesia for patients undergoing mastectomy will result in less pain and less narcotic consumption in the recovery room. The investigators will also verify the impact of that substitution on nausea and vomiting, on the time spent in the recovery room and on chronic postsurgical pain (3 and 6 months).

Finally, the investigators will see the impact on breast cancer recurrence 5 years after the surgery.

Inclusion Criteria:

• Woman
• 18 to 65 years old
• ASA 1 or 2
• First breast surgery
• Unilateral breast cancer
• Partial mastectomy or radical modified mastectomy ± axillary dissection

Exclusion Criteria:

• Allergy or contrindication to any medication figuring in the protocol or to Aspirin
• Patient taking betablocking drug drug or lanoxin or calcic channels blocking drug
• Narcotic consumption in the past month of 10 mg/day of morphine equivalent
• Chronic pain
• Moderate to severe asthma
• BMI of more than 40
• Diabetes
• Chronic renal or hepatic faiure
• Heart failure
• Anticipated difficult airway
• High grade heart block or bifascicular block
• Mental retardation