Chronic Pain, Cytokines, Dexamethasone, Thoracic Surgery
Conditions
Brief summary
Post thoracotomy pain syndrome still affects 50% of patients after a thoracic surgery. Pathogenesis is unclear but there is growing evidence that neuro inflammation may play a significant role. Dexamethasone is a very potent anti-inflammatory drug. The hypothesis of this study is that dexamethasone, given pre operatively, would help reduce the incidence of post thoracotomy pain syndrome 3 months after surgery, by reducing the inflammatory response, in patients undergoing elective thoracic surgery that includes thoracic epidural analgesia.
Interventions
DRUGDexamethasone
10 mg (2.5 ml)
DRUGNormal Saline
2.5 mL normal saline
Sponsors
Maisonneuve-Rosemont Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* elective thoracic surgery using a thoracotomy incision and thoracic epidural analgesia * ASA I-III * age 18-75 yo
Exclusion criteria
* contra-indication to thoracic epidural analgesia * patient refusal * patients already taking cortisone or dexamethasone * patients on chronic opioid medication
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| cytokine elevation | 24 h after surgery |
Secondary
| Measure | Time frame |
|---|---|
| incidence of post thoracotomy pain syndrome | 3 months after surgery |
| incisional and shoulder pain | acute post operative period |
| Brief pain inventory questionnaire | three months after surgery |
| Leeds Assessment of Neuropathic Signs and Symptoms questionnaire | three and six months after surgery |
| cytokine elevation | 1h after surgery |
Countries
Canada
Contacts
Primary ContactVéronique Brulotte, MD, MSc
Backup ContactNadia Godin, nurse
Outcome results
None listed