Study of Ketamine and Dexmedetomidine Alone and Combined to Reduce Morphine Use After Video-Assisted Thoracic Surgery VATS

What this Trial Is About

Researchers are studying postoperative pain management in patients undergoing elective video-assisted thoracic surgery VATS for lung resection. This study focuses on comparing the effects of two non-opioid drugs, ketamine and dexmedetomidine, alone and in combination, to reduce the need for morphine after surgery. The goal is to see if combining these drugs can further decrease morphine use by 30% within 24 hours after surgery, which may improve recovery and reduce opioid-related side effects. The study involves three groups of patients receiving different intraoperative infusions ketamine alone, dexmedetomidine alone, or a combination of ketamine and dexmedetomidine. Each drug is given as a bolus followed by continuous infusion during surgery. All participants receive opioid patient-controlled analgesia PCA along with acetaminophen and NSAIDs for postoperative pain control. The study lasts about one year and uses a randomized, double-blind design to compare morphine consumption and other pain-related outcomes. Participants will be closely monitored during and after surgery, with assessments of morphine use, pain scores at rest and during coughing at 24 and 48 hours, intraoperative fentanyl use, time to chest tube removal, hospital discharge timing, and the presence of chronic pain after three months. Side effects like ketamine-induced psychomimetic reactions and episodes of slow heart rate during surgery will also be recorded. These measures aim to understand better how these drug infusions affect pain management and recovery after VATS.

Dexmedetomidine and Ketamine in VATS Surgery