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Dexmedetomidine and Ketamine in VATS Surgery

Postoperative Pain | Opioid Use

Postoperative pain after VATS surgery is significant and associated with moderate to high post operative morphine requirements, which can cause opioid related side effects and delay postoperative recovery. To reduce this requirement, multimodal analgesia with non opioid medication such as dexmedetomidine and ketamine can be used. These drugs have demonstrated significant opioid-sparing properties after various types of surgeries. However, very little is known about their ability to do so in VATS surgery. Also, their relative opioid-sparing properties have not been compared, and it is not known whether their combined use can lead to an additional opioid-sparing effect. The primary goal of this study will be to determine the impact of a combined intra operative infusion of ketamine and dexmedetomidine on postoperative morphine requirements in patients undergoing elective VATS, compared to both these drugs infused separately.

The hypothesis is that this combined infusion will lead to a 30% further reduction in morphine requirements, 24h after surgery, compared to both these drugs infused separately.

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Participation Requirements

  • Sex:

    ALL

  • Eligible Ages:

    18 to 80

Participation Criteria

Inclusion Criteria:

* Patients aged 18-80 years old
* American Society of Anesthesiology physical status I-III
* Elective Video-Assisted Thoracic Surgery for pulmonary resection

Exclusion Criteria:

* Patients for which a regional anesthesia technique is planned for postoperative analgesia.
* Patients taking beta-blockers preoperatively.
* Patients with chronic pain taking \>60 mg morphine PO daily (or its equivalent).
* Patients taking pregabalin, gabapentin, amitryptillin, nortryptillin and/or duloxetin.
* Documented allergy to ketamine and/or dexmedetomidine.
* Pregnancy
* Inability to give informed consent
* Linguistic barrier.
* Patient refusal

Study Location

Ciusss
Ciusss
Montréal, Quebec
Canada

Contact Study Team

Primary Contact

Nadia Godin, RN

Study Sponsored By
Ciusss de L'Est de l'Île de Montréal
Participants Required
More Information
Study ID: NCT03596424