Role of Dexamethasone in Multimodal Analgesia for Postoperative Pain in Thoracic Surgery
NCT ID: NCT04325984
Last Updated: 2020-03-30
Study Results
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Basic Information
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COMPLETED
62 participants
OBSERVATIONAL
2017-08-29
2019-03-06
Brief Summary
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Detailed Description
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The research wants to assess the presence of additional analgesic properties, besides the well known antiemetic effect, in the intraoperative administration of dexamethasone, and the possible postoperative complications, such as wound infections and hyperglycaemia.
The rational is to ameliorate the anaesthesiological management, in particular with a view to a opioid-sparing analgesia in thoracic patients.
To do so, we enrolled thoracic patients, who underwent elective lobectomy, segmentectomy or atypical resection surgery with a mini-thoracotomy approach or video-assisted thoracoscopic surgery (VATS).
We selected two groups: one in which patients were administered dexamethasone 8 mg at the moment of induction, and the other one in which patients didn't received dexamethasone, but ondansetron 4 mg at the end of surgery. Both groups received other antiemetic drugs based on Apfel score and multimodal analgesia, comprising loco-regional analgesia, opioids and other analgesic drugs administration.
The we checked morphine consumption and Numerical Rating Scale (NRS) values for pain in the first 24 hours after surgery.
Moreover we evaluate Post-Operative Nausea and Vomiting (PONV), intra- and post-operative blood glucose levels and wound infection.
Conditions
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Study Design
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COHORT
RETROSPECTIVE
Study Groups
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Dexamethasone group
Group of patients receiving dexamethasone 8 mg as part of the multimodal analgesia.
Dexamethasone
To the Dexamethasone group, at the moment of the induction of anaesthesia, dexamethasone 8 mg is administered.
Control group
Group of patients receiving multimodal analgesia, not comprising dexamethasone; moreover, ondansetron 4 mg is administered for the control of PONV.
No interventions assigned to this group
Interventions
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Dexamethasone
To the Dexamethasone group, at the moment of the induction of anaesthesia, dexamethasone 8 mg is administered.
Eligibility Criteria
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Inclusion Criteria
* ASA I-III
* Lobectomy, segmentectomy or atypical resection surgery with a mini-thoracotomy approach or VATS
Exclusion Criteria
* Chronic therapy with medium-high doses of corticosteroids
* Chronic therapy with opioids
* METS ≤ 4, defining an overall decreased cardiovascular fitness
* Urgent or emergency surgery
* Allergy to the active ingredient of the drug used
* Kidney failure at stage III or more
* Liver failure
* Pregnancy
* Drug addiction, patients with a history of drug abuse
* Corrected Qt interval (QTc) \> 0,45 for males and 0,47 for women
18 Years
ALL
No
Sponsors
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University of Trieste
OTHER
Responsible Party
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Marzia Umari
Principal Investigator
Principal Investigators
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Umberto Lucangelo, MD PhD
Role: STUDY_DIRECTOR
University of Trieste
Marzia Umari, MD
Role: PRINCIPAL_INVESTIGATOR
University of Trieste
Locations
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Cattinara Hospital
Trieste, , Italy
Countries
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References
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Wenk M, Schug SA. Perioperative pain management after thoracotomy. Curr Opin Anaesthesiol. 2011 Feb;24(1):8-12. doi: 10.1097/ACO.0b013e3283414175.
Doan LV, Augustus J, Androphy R, Schechter D, Gharibo C. Mitigating the impact of acute and chronic post-thoracotomy pain. J Cardiothorac Vasc Anesth. 2014 Aug;28(4):1048-56. doi: 10.1053/j.jvca.2014.02.021. No abstract available.
Henzi I, Walder B, Tramer MR. Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review. Anesth Analg. 2000 Jan;90(1):186-94. doi: 10.1097/00000539-200001000-00038.
Waldron NH, Jones CA, Gan TJ, Allen TK, Habib AS. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis. Br J Anaesth. 2013 Feb;110(2):191-200. doi: 10.1093/bja/aes431. Epub 2012 Dec 5.
Kakodkar PS. Routine use of dexamethasone for postoperative nausea and vomiting: the case for. Anaesthesia. 2013 Sep;68(9):889-91. doi: 10.1111/anae.12308. Epub 2013 Jul 15. No abstract available.
Standards of Medical Care in Diabetes-2016: Summary of Revisions. Diabetes Care. 2016 Jan;39 Suppl 1:S4-5. doi: 10.2337/dc16-S003. No abstract available.
Related Links
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Other Identifiers
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173_2018_DexaPOP
Identifier Type: -
Identifier Source: org_study_id
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