Overview
In 230 patients undergoing mastectomy, the investigators will compare opioid-free anesthesia (OFA) versus conventional opioid-based anesthesia in terms of chronic pain. The enrolled patients will be randomly assigned into two groups with 1:1 ratio. Chronic pain will be evaluated at 1 year after mastectomy based on the Breast Cancer Pain Questionnaire (BCPQ). Baseline pain sensitivity test and psychologic evaluation will be done before operation.
Description
Study population
- All of patients will undergo mastectomy with or without immediate breast reconstruction.
- 230 patients will be enrolled.
Intervention
- OFA group will be sedated using dexmedetomidine and lidocaine.
- Conventional opioid anesthesia group will be sedated using remifentanil.
Pain screening
- Breast Cancer Pain Questionnaire (BCPQ)
- Pain-detect, HADS, EQ-5D, PHQ-15 (somatic symptom), PCS (pain catastrophizing), BFI (big five inventory), HAM-A&D, Pressure algometry (Pain sensitivity), Quantitative sensory test (pinprick)
Eligibility
Inclusion Criteria:
- All of patients will undergo mastectomy with or without immediate breast reconstruction.
Exclusion Criteria:
- Previous history of breast surgery
- Allergy to drug
- Other cancer history
- Underlying psychologic disorder
- Patients with chronic pain requiring pain killers
- Baseline SpO2 <95%
- Left ventricular EF <40%
- Bradycardia as HR <50 bpm
- BMI >35kg/m2
- Pregnant woman