Opioid Free Versus Opioid Based Anaesthesia for Free Flap Reconstruction Surgery of the Breast: A Phase III Multicentric Randomized Controlled Study.

Inclusion criteria

• Women aged 18 or older.
• Patients with a French health insurance coverage (having a French social security number).
• Patient eligible for free flap reconstruction surgery of the breastunder general anaesthesia.
• Patient who has given written consent to participate in accordance with the regulations.
• Having a negative blood pregnancy test for patients of childbea ring age.

Exclusion criteria

• Allergy or intolerance to any of the drugs (dexmedetomidine, remifentanil, lidocaine, propofol, dexamethasone, kétamine, ketoprofen, nefopam, paracetamol, morphine, ropivacaine, droperidol, ondansetron).
• Known history of heart failure, arrhythmias and/or ischemic heart disease and/or severe renal insufficiency.
• Pulse below 50bpm during anaesthesia consultation and/or under beta blocker treatment.
• Treatment with ACEI/ARB.
• Severe asthma.
• Symptomatic gastric or duodenal ulcer with or without treatment.
• Baseline systolic blood pressure < 100 mmHg.
• Chronic preoperative pain and/or use of WHO ladder step 2 or 3 analgesics preoperatively.
• Patient already included in another therapeutic trial evaluating an experimental molecule.
• Persons deprived of liberty or under guardianship.
• Patients with suspected difficulties in assessing pain on a scale.
• Inability to undergo trial medical monitoring due to geographic, social or psychological reasons.