Dexamethasone for Reduction of Post Thoracotomy Pain Syndrome

Impact of Dexamethasone on the Post Operative Inflammatory Response and on the Occurrence of Post Thoracotomy Pain Syndrome

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.

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