Effect of low dose intravenous dexmedetomidine on post anesthesia discharge after daycase breast cancer surgery: a randomized controlled trial

Abstract

Background: In resource-limited, high-volume cancer centers, even small reductions in recovery times can yield meaningful clinical and economic benefits. Therefore, local validation of emerging international findings on dexmedetomidine’s role in enhancing recovery is warranted. This study assessed whether low-dose intraoperative dexmedetomidine in day-case breast cancer surgery could shorten PACU (post-anesthesia care unit), total discharge times and increase early-discharge rates compared with standard anesthetic care.

Methodology: A prospective double blinded randomized controlled trial was conducted at the Department of Anesthesia, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, between September 2023 and July 2025. 82 women aged 18–60 years, ASA (American Society of Anesthesiologists) class I-II, scheduled for same-day elective breast surgery, were randomly allocated into two equal groups. Group A received dexmedetomidine infusion (0.6 µg/kg/h) intra-operatively, while Group B was given placebo.  The primary outcome included the frequency of patients achieving early discharge (≤120 minutes).

Results: Early discharge was achieved in all patients receiving dexmedetomidine (100%) and in 37 patients from the control group (90.2%); the difference was not statistically significant (P = 0.116, Fisher’s Exact). The dexmedetomidine group demonstrated a significantly shorter PACU discharge time (35.6 ± 11.0 min vs. 51.3 ± 20.5 min; P < 0.001), chair recovery time (28.1 ± 11.0 min vs. 38.9 ± 17.6 min; P = 0.01), and total discharge time (59.6 ± 18.5 min vs. 80.7 ± 27.4 min; P < 0.001).

Conclusion: Low-dose intraoperative dexmedetomidine enhances postoperative recovery and shortens discharge time without adverse effects, supporting its role as a useful adjunct for ambulatory breast surgery anesthesia.

Keywords: Dexmedetomidine, Day-case surgery, Breast cancer, Post-anesthesia care, Ambulatory anesthesia.

Citation: Saleem Y, Iqbal A, Ashfaq AD. Effect of low dose intravenous dexmedetomidine on post anesthesia discharge after daycase breast cancer surgery: a randomized controlled trial. Anaesth. pain intensive care 2026;30(3):xxxxxxxx. DOI: 10.35975/apic.v30i3.3171

Received: November 04, 2025; Revised: January 11, 2026; Accepted: February 27, 2026