Postoperative Analgesia Impact of Narcotic Free Anesthesia

Université de Sherbrooke84 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

QUADRUPLE

Enrollment

Conditions

Pain, Postoperative Breast Cancer Postoperative Nausea and Vomiting

Interventions

fentanylDRUG

Use of esmolol and metoprolol compared to use of fentanyl for hemodynamic control during general anesthesia. At induction, fentanyl (2 mcg/kg) is replaced by esmolol (1 mg/kg). During the case, with a standardised anesthesia, response to surgical stimulation will be medicated either by fentanyl (50 mcg aliquot) or metropolol (2.5 mg), for a maximum of 6 doses. After this, fentanyl will be given unblindly.

beta-blocker (esmolol, metropolol)DRUG

esmolol is used at induction and lopressor during surgery instead of fentanyl in response to surgical stimulation.

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

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

Locations (1)

Centre Hospitalier Universitaire de Sherbrooke

Sherbrooke, Quebec, Canada

Outcomes

Primary Outcomes

Postoperative consumption of narcotic in recovery room

Time frame: Immediately after surgery

Secondary Outcomes

Pain level in recovery room

Time frame: immediately after surgery

Occurence of nausea and vomiting in the recovery room

Time frame: immediately after surgery

Time spent in recovery room

Time frame: immediately after surgery

Chronic post-surgical pain

Time frame: 3 and 6 months

Reccurence of breast cancer

Time frame: 5 years

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.