TY - JOUR
T1 - High-dose glucocorticoids in the treatment of postoperative pain after video-assisted thoracoscopic surgery-protocol for systematic review and meta-analysis
AU - Vorm, Bertram
AU - Jeppesen, Anni Nørgaard
AU - Hansen, Lene Mølgaard
AU - Lumholdt, Mads
AU - Klitgaard, Thomas Lass
AU - Danielsen, Allan Vestergaard
AU - Juhl-Olsen, Peter
AU - Sperling, Phillip
AU - Bisgaard, Jannie
N1 - © 2025 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.
PY - 2025/3
Y1 - 2025/3
N2 - BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is widely used in lung cancer surgery, as this technique causes less pain and faster recovery than open thoracotomy. However, significant postoperative pain persists in a number of patients, often leading to increased opioid use and opioid-related adverse events in addition to prolonged admission times. Perioperatively administered glucocorticoids have been demonstrated effective in reducing pain after other types of surgeries, but the effect in VATS remains unclear.METHODS: This systematic review will assess the impact of glucocorticoids on postoperative pain in adult patients undergoing VATS. We will include randomised trials comparing higher doses of glucocorticoids to lower doses, placebo or no treatment. The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement and Cochrane methodology. The certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation system. The primary outcome is standardised dynamic pain scores within 24 h. Secondary outcomes are opioid use, time to first mobilisation, length of hospital stay and numeric rating score >3 at any point within the first 24 h following surgery. Exploratory outcomes are opioid-related adverse effects and glucocorticoid-related adverse effects classified in major and minor events. Data will be meta-analysed with sensitivity and subgroup analyses and trial sequential analyses. Furthermore, we will assess the risk of reporting bias and heterogeneity.CONCLUSION: This systematic review and meta-analysis will provide an overview of the current evidence of how glucocorticoids affect postoperative pain and recovery in adult patients undergoing VATS.
AB - BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is widely used in lung cancer surgery, as this technique causes less pain and faster recovery than open thoracotomy. However, significant postoperative pain persists in a number of patients, often leading to increased opioid use and opioid-related adverse events in addition to prolonged admission times. Perioperatively administered glucocorticoids have been demonstrated effective in reducing pain after other types of surgeries, but the effect in VATS remains unclear.METHODS: This systematic review will assess the impact of glucocorticoids on postoperative pain in adult patients undergoing VATS. We will include randomised trials comparing higher doses of glucocorticoids to lower doses, placebo or no treatment. The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement and Cochrane methodology. The certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation system. The primary outcome is standardised dynamic pain scores within 24 h. Secondary outcomes are opioid use, time to first mobilisation, length of hospital stay and numeric rating score >3 at any point within the first 24 h following surgery. Exploratory outcomes are opioid-related adverse effects and glucocorticoid-related adverse effects classified in major and minor events. Data will be meta-analysed with sensitivity and subgroup analyses and trial sequential analyses. Furthermore, we will assess the risk of reporting bias and heterogeneity.CONCLUSION: This systematic review and meta-analysis will provide an overview of the current evidence of how glucocorticoids affect postoperative pain and recovery in adult patients undergoing VATS.
KW - Analgesics, Opioid/therapeutic use
KW - Glucocorticoids/administration & dosage
KW - Humans
KW - Meta-Analysis as Topic
KW - Pain, Postoperative/drug therapy
KW - Systematic Reviews as Topic
KW - Thoracic Surgery, Video-Assisted/adverse effects
KW - postoperative pain
KW - meta-analysis
KW - lung resection surgery
KW - glucocorticoids
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=85215564473&partnerID=8YFLogxK
U2 - 10.1111/aas.14577
DO - 10.1111/aas.14577
M3 - Review
C2 - 39853688
SN - 0001-5172
VL - 69
SP - e14577
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
IS - 3
M1 - e14577
ER -