A Prospective Randomized Controlled Trial Comparing Dexmedetomidine and Propofol for Sedation and Analgesia for Incision and Drainage Procedure in Lactational Breast Abscess

Abstract

BACKGROUND A lactational breast abscess is a localized accumulation of infected fluid in breast tissue, due to which many women stop breastfeeding. Lack of adequate anaesthesia is the most common factor limiting incision and drainage (I & D) in the Emergency Department (ED). The present study was planned to compare the efficacy of dexmedetomidine and propofol among patients undergoing incision and drainage (I & D) for lactational breast abscess. METHODS A total of 50 consenting patients in the age group of 18-40 years, American Society of Anaesthesiologists (ASA) I and II undergoing incision and drainage (I & D) of lactational breast abscess were included in the study. The patients were divided into two groups of 25 patients each. Group D received dexmedetomidine and Group P received Propofol. Sedation score, heart rate (HR), systolic blood pressure (SBP), requirement of rescue injection fentanyl, patient satisfaction, surgeon satisfaction and complications were recorded. RESULTS Baseline values of the mean heart rate and mean systolic blood pressure were comparable between the groups, but intraoperatively, there was a statistically significant reduction in the mean heart rate and mean systolic blood pressure. There was statistically significant fall in systolic blood pressure in group P [8 (32%) vs 2 (8%)]. There was statistically significant difference in requirement of injection fentanyl in group D [3 (6%) vs 12 (24)]. Both, patient satisfaction and surgeon satisfaction were significantly better in D group when compared to P group. Sedation score and time to achieve adequate RSS was comparable between both the groups. CONCLUSIONS Dexmedetomidine seems to be a better drug with minimal haemodynamic instability when compared to propofol.