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

Exclusion Criteria

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