To investigate the effect of intercostal blockade with and without adjuvants.
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive routine procedure. It's less invasive than thoracotomy but postoperative pain is still a problem. At Aalborg University Hospital, intercostal blockades with bupivacaine is used as standard pain treatment for patients undergoing VATS. Adding adjuvants to the blockades may prolong the effect. The aim of this study is to investigate if intercostal nerve blockade with adjuvants (intravenous (IV) dexamethasone) will result in better pain management. The primary plan was to evaluate the effect of adding IV dexamethasone and perineural adrenaline, but due to adverse effects, adrenaline was first reduced and later removed from the intervention (amendment protocol N-20200040 approved by the Ethics Committee of Northern Jutland on February 2nd 2021).
Study Type
OBSERVATIONAL
Enrollment
45
Intravenous dexamethasone 8 mg. Given once at the end of surgery.
Bupivacaine dose according to weight. \<60 kg: Total dose 100mg 60-90kg: Total dose 150mg \>90kg: Total dose 200mg Given once at the end of surgery.
Aalborg University Hospital
Aalborg, Region of Northern Jutland, Denmark
Total equipotent dose of opioids
Sum of equipotent opioid doses during the first 24 hours after surgery
Time frame: 24 hours
Time to first administration of opioids after surgery
In hours and minuts
Time frame: 48 hours
Numerical rating scale score
Pain score reported by the patient after surgery from 0 (no pain) to 10 (worst imaginable pain) in whole numbers.
Time frame: 24 hours
Time for full mobilization
The total time for full mobilization (walk with support)
Time frame: Through study completion, an average of 1 week
Total dose of non-opioid analgesics
Sum of non-opioid doses during the first 24 hours after surgery
Time frame: 24 hours
The need for pain medication at discharge
The need for pain medication at discharge (all forms, type, dose)
Time frame: At discharge from hospital, an average of 1 week
Postoperative complication (Empyema)
Empyema (yes/no) as complication to the surgery described in the patients journal at discharge (epicrisis)
Time frame: At discharge from hospital, an average of 1 week
Postoperative complication (Air leakage)
Air leakage (yes/no) as complication to the surgery described in the patients journal at discharge (epicrisis)
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Time frame: At discharge from hospital, an average of 1 week
Postoperative complication (Reoperation)
Reoperation (yes/no) as complication to the surgery described in the patients journal at discharge (epicrisis)
Time frame: At discharge from hospital, an average of 1 week
Postoperative complication (Pneumonia)
Pneumonia (yes/no) as complication to the surgery described in the patients journal at discharge (epicrisis)
Time frame: At discharge from hospital, an average of 1 week
Postoperative complication (Drainage of pleural effusion)
Pleural effusion (yes/no) as complication to the surgery described in the patients journal at discharge (epicrisis)
Time frame: At discharge from hospital, an average of 1 week
Postoperative complication (Oyxgen therapy)
The need for supplemental oxygen therapy and need for mechanical ventilation (yes/no) as complication to the surgery described in the patients journal at discharge (epicrisis)
Time frame: At discharge from hospital, an average of 1 week