Appropriate dose of dexmedetomidine assisted sedation in minimally invasive breast surgery

doi:10.12092/j.issn.1009-2501.2025.08.012

Abstract

Abstract: AIM: To investigate the appropriate dose of intravenous dexmedetomidine (Dex) for sedation in minimally invasive breast surgery under regional block. METHODS: A total of 120 patients with multiple breast masses were selected and divided into Dex 0.5 μg/kg group (group D₁), Dex 0.75 μg/kg group (group D₂), Dex 1.0 μg/kg group (group D₃) and normal saline group (group C) according to the random number table method. After intravenous injection of test drugs, minimally invasive rotary cutting under retromammary space anesthesia was performed. The optimal sedation rate during operation, the optimal sedation rate after operation, Ramsay sedation scores were recorded before anesthesia, at the end of intravenous administration, at the retromammary space anesthesia, at the beginning of surgery, 5 min after surgery, at the end of surgery, 30 min after administration, and 60 min after administration, visual analogue scale (VAS), vital signs (SBP, DBP, HR, SpO₂), the incidence of moderate and above pain (VAS>3) and adverse reactions were observed. The optimal sedation was defined as intraoperative Ramsay score 2-4 points and postoperative Ramsay score 2-3 points. RESULTS: Dex had a dose-dependent sedative and analgesic effect. The optimal sedation rate during operation in group D₂ and D₃ was significantly higher than that in group C and D₁, and the optimal sedation rate after operation in group D₂ was the highest. The rate of VAS score greater than 3 points in group D₂ and group D₃ was significantly lower than that in group C and group D₁, and there was no statistical difference between group D₂ and group D₃. The incidence of dizziness in group D₂and group D₃ was higher than that in group C and group D₁. There was no significant difference in the incidence of hypotension, hypertension, severe bradycardia, hypoxemia and nausea among the groups. CONCLUSION: Preoperative single intravenous application of 0.75 μg/kg dexmedetomidine has a definite sedative and analgesic effect, and the optimal sedation rate during and after operation is high. It is an appropriate dose for sedation assisted by minimally invasive breast surgery under regional block.

Key words: dexmedetomidine, sedation, regional block, minimally invasive breast atherectomy

CLC Number:

R614

CHEN Jianxiao^{1, 2}, LV Hao², GUO Xiaowen³. Appropriate dose of dexmedetomidine assisted sedation in minimally invasive breast surgery[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2025, 30(8): 1105-1111.

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