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.