High Dose Dexamethasone to Reduce Postoperative Pain After Video-Assisted Thoracoscopic Surgery Lobectomy /Segmentectomy

Summary

The aim is to conduct a randomized controlled trial (RCT) with a high dose arm (1mg/kg) vs a low dose (8mg in total) of steroid (Dexamethasone) given intravenous (IV) after the induction of anesthesia to "High-pain-responders" in patients undergoing VATS lobectomy/segmentectomy. The hypothesis is that a high dose of Dexamethasone can lower pain when coughing in the morning after VATS lobectomy/segmentectomy, in patients scoring as "High-pain-responders" on the Pain-Catastrophizing-Scale

Eligibility

Inclusion Criteria:

* Age ≥ 18 year
* Able to understand written and spoken Danish language
* PCS ≥20
* Signed written informed consent form.
* Patient planned to elective VATS lobectomy/segmentectomy

Exclusion Criteria:

* Patients undergoing systemic glucocorticoid or other immunosuppressive therapies, ex-cluding inhaled steroids.

  * Individuals with diabetes requiring insulin treatment.
  * Pregnant or breastfeeding patients.
  * Patients with known allergies to the study drug.
  * Individuals with mental disabilities that may impair their capacity to provide informed consent or compromise the validity of data collection.
  * Patients with diagnosed schizophrenia, active psychosis, bipolar disorder, or a history of ongoing treatment with antipsychotic and/or antidepressant medications.
  * Individuals with altered pain perception due to other conditions or injuries, such as spi-nal cord or brain injuries, severe polyneuropathies, or neurological disorders.
  * Regular users of opioid medications.
  * Patients requiring reoperation within the first two postoperative days.
  * Individuals undergoing conversion to a surgical procedure other than VATS lobecto-my/segmentectomy.

Conditions6

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