title: Dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia for appropriate surgical field visibility during modified radical mastectomy with i-gel®: a randomized control study.
abstract: BACKGROUND
  Modified radical mastectomy is associated with appreciable blood loss, while endotracheal intubation leads to elevated hemodynamic responses. The present study aimed to evaluate the clinical efficacy of dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia during modified radical mastectomy with I-Gel.
  
  
  METHODS
  Sixty adult consenting female patients, of American Society of Anesthesiologists physical status 1 to 2 and aged 4,065 years, were blindly randomized into two groups of 30 patients each. The patients in Group I received intravenous dexmedetomidine at a loading dose of 1 µg/kg over 10 min, followed by maintenance infusion of 0.4 to 0.7 µg/kg/h, while patients in Group II were administered an identical amount of saline infusion until 15 min prior to the end of surgery. The primary end point was bleeding at the surgical field and hemodynamic changes; requirement of isoflurane, intraoperative fentanyl consumption and recovery time were assessed as secondary outcomes.
  
  
  RESULTS
  The patients receiving dexmedetomidine infusion showed significantly less bleeding at the surgical field (P < 0.05). A statistically significant reduction was also observed in the percentage of isoflurane required (0.82 ± 0.80%) to maintain the systolic blood pressure between 100 and 110 mmHg in patients receiving dexmedetomidine infusion compared with the Group II (1.50 ± 0.90%). The mean intraoperative fentanyl consumption in patients in the Group I was also significantly lower compared with that of the Group II (38.43 ± 5.40 µg vs. 75.12 ± 4.60 µg). The mean recovery time from anesthesia did not show any clinically significant difference between the groups.
  
  
  CONCLUSIONS
  Dexmedetomidine infusion can be used safely to decrease the bleeding at the surgical field with smooth recovery from anesthesia.
authors.affiliation: Department of Anaesthesiology and Critical Care, Subharti Medical College, Swami Vivekanand University, Meerut, India.
authors.forename: Kumkum
authors.identifier: 0000-0002-7516-9455
authors.initials: K
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesiology and Critical Care, Subharti Medical College, Swami Vivekanand University, Meerut, India.
authors.forename: Bhawana
authors.initials: B
authors.lastname: Rastogi
authors.affiliation: Department of Radiodiagnosis and Interventional Imaging, Subharti Medical College, Swami Vivekanand University, Meerut, India.
authors.forename: Prashant K
authors.initials: PK
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesiology and Critical Care, Subharti Medical College, Swami Vivekanand University, Meerut, India.
authors.forename: Ivesh
authors.initials: I
authors.lastname: Singh
authors.affiliation: Department of Anaesthesiology and Critical Care, Subharti Medical College, Swami Vivekanand University, Meerut, India.
authors.forename: Vijendra Pal
authors.initials: VP
authors.lastname: Singh
authors.affiliation: Department of Anaesthesiology and Critical Care, Subharti Medical College, Swami Vivekanand University, Meerut, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Jain
keywords: Dexmedetomidine; Modified radical mastectomy; Supraglottic airways; Surgial bleeding; Surgical field; i-gel