Infusion of Dexmedetomidine Versus Lidocaine in Management of Acute Postoperative Pain After Modified Radical Mastectomy

Intraoperative Intravenous Infusion of Dexmedetomidine Versus Lidocaine in Management of Acute Postoperative Pain After Modified Radical Mastectomy: A Randomized Trial

This study aims to compare the effect of intraoperative intravenous infusion of dexmedetomidine and lidocaine in the management of acute postoperative pain after mastectomy.

Postoperative pain control continues to remain suboptimal, despite multimodal analgesia regimes, minimally invasive surgical techniques, and enhanced recovery programs. Acute postoperative pain hinders patients' functional recovery and represents one of the greatest predictive factors for transition to chronic postsurgical pain.

Among adjuvants, dexmedetomidine, a highly selective α2 adrenoreceptor agonist, and lidocaine, a well-established local anesthetic, seem promising for this purpose.

Inclusion Criteria:

• Age from 18 to 65 years.
• American Society of Anesthesiology (ASA) physical status II.
• Body mass index (BMI) 18.5-35 kg/m2.
• Scheduled for modified radical mastectomy.

Exclusion Criteria:

• Patient's refusal.
• Contraindication to the use of local anesthetics.
• Cardiovascular disease.
• Significant renal/hepatic impairment
• Insulin-dependent diabetes mellitus.
• Central nervous system or psychiatric disease.
• Use of opioids/steroids/clonidine/other α2 agonist/analgesics or any drugs acting on the central nervous system during the previous 2 weeks.
• Drug/alcohol abuse.
• Inability to comprehend the pain assessment scale.