The Effectiveness of Dexmedetomidine in Vacuum-Assisted Breast Biopsy Under Monitored Anesthesia Care
Kosin Medical Journal
Vacuum-assisted breast biopsy (VABB; Mammotome ® ) is a minimally invasive method usually performed under ultrasound guidance. It has a smaller incision, less blood loss, a shorter recovery time, and a shorter operative time than excisional surgery. 1 Conventionally, VABB is performed under local anesthesia using an 8-14 gauge needle in outpatient settings; 1,2 however, procedure dura-tion, large needle diameter, pathologic diagnosis, blood loss, and the associated pain 3,4 can be physical and
... an be physical and mental stressors to patients. 5, 6 Monitored anesthesia care (MAC) is a diagnostic or therapeutic procedure performed under the supervision of an anesthesiologist to reduce residual sedation through appropriate pain relief and for a quick discharge. It has been described Objectives: Vacuum-assisted breast biopsy (VABB) is a widely used technique for the diagnosis of breast lesions. It is carried out with local anesthesia, but procedural pain and stress are still problematic. Dexmedetomidine is a α-2 receptor agonist that can sedate without significant respiratory depression. The study aimed to report the effectiveness of sedation with monitored anesthesia care (MAC) using dexmedetomidine in VABB. Methods: This was a retrospective chart review of patients who received VABB under MAC with dexmedetomidine. Forty-seven patients during the period of February 2015 to July 2016 were included. We collected data on patient characteristics, infusion drug and dose, induction to incision time, anesthetic, operation, and recovery time and other complications and vital signs. Results: The mean operating time was 50.1 ± 24.9 minutes, and the anesthetic time was 71.2 ± 28.3 minutes. The mean time from induction to incision was 17.0 ± 5.2 minutes, and the recovery time was 20.1 ± 10.3 minutes. None of the patients needed an advanced airway management. Further, none of them showed hemodynamic instability. Conclusions: VABB was successfully performed with MAC using dexmedetomidine, and there was no respiratory depression or hemodynamic instability.