This trial is going to evaluate the safety and effectiveness of intranasal DEX(dexmedetomidine) in breast lumpectomy under local anaesthesia,and to investigate the optimal dose of intranasal DEX in breast lumpectomy.
Breast lumpectomy associated with a high level of anxiety, fear and pain requires fast and effective anaesthesia techniques. Presently, this procedure is usually performed under general or local anaesthesia. General anaesthesia provides an effective sedation; however, for minor procedures, general anaesthesia is resource-intensive and postoperative complications, such as nausea, vomiting or extended time to ambulation, are more likely. Local anaesthesia alone may be uncomfortable or uncooperative for patients. Therefore, an efficient drug regimen is required that reduces analgesic consumption, minimises opioid-related side effects and shortens post-anaesthesia care unit (PACU) stay following surgery. Dexmedetomidine (DEX) is a highly selective α2 adrenoreceptor agonist that provides sedation without respiratory depression. Its sedative, anxiolytic, analgesic and haemodynamic effects have made it a useful adjunct to anaesthesia and sedation. DEX may provide a conscious sedation under monitored anaesthesia care (MAC) that is a logical middle ground between general anaesthesia and local anaesthesia. Intranasal DEX was recently shown to provide satisfactory anaesthesia and premedication sedation in healthy volunteers and paediatric patients. The intranasal route is not only effective, but also well-tolerated and convenient This trial is going to evaluate the safety and effectiveness of intranasal DEX(dexmedetomidine) in breast lumpectomy under local anaesthesia, and to investigate the optimal dose of intranasal DEX in breast lumpectomy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
100
0.9% saline intranasally 45 min before surgery using a computer-generated random number table.
dexmedetomidine 1µg.kg-1 intranasally 45 min before surgery using a computer-generated random number table.
Dexmedetomidine 1.5µg.kg-1 intranasally 45 min before surgery using a computer-generated random number table.
Sedation changes using the modified Observer's Assessment of Alertness/Sedation (OAA/S) scale
Time frame: before surgery,during surgery and after surgery for sedation changes,assessed up to 2 hours
pain scores changes by pain NRS scores
Time frame: before surgery,during surgery and after surgery for pain scores,assessed up to 2 hours
Adverse event that is related to treatment:severe sinus bradycardia
bradycardia (defined as HR \< 50 bpm)
Time frame: perioperative period
Adverse event that is related to treatment:hypotension
hypotension (defined as SBP \< 90 mmHg)
Time frame: perioperative period
Adverse event that is related to treatment:nausea and vomiting
Time frame: perioperative period
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dexmedetomidine 2µg.kg-1 intranasally 45 min before surgery using a computer-generated random number table.