Low Dose of Methylprednisolone for Pain and Immune Function After Thoracic Surgery

This study evaluated the effects of single low-dose preoperative methylprednisolone (MP) on the immunologic function and postoperative pain of patients undergoing elective video-assisted thoracoscopic surgery under general anesthesia.

The study randomly assigned 81 patients who underwent elective video-assisted thoracoscopic surgery to the MP group or the control group. The T-lymphocyte subsets of CD3⁺, CD4⁺, and CD8⁺, and the CD4⁺/CD8⁺ ratio at T₀ (before anesthesia), T₁ (after operation), and T₂ (24 hours after operation) were recorded. Also recorded were postoperative rest and cough pain scores and postoperative adverse effects and surgery complications.

Compared with T₀, the levels of CD3⁺ and CD4⁺ subsets and CD4⁺/CD8⁺ were significantly decreased, and the level of CD8⁺ was increased after surgery in both groups. There was no significant difference in the variation of CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ between the MP group and the control group. The rest and cough pain of patients in the MP group was significantly lower compared with the control group at 2, 4, 6, and 24 hours after surgery. The incidences of nausea and vomiting and dizziness were also significantly higher in the control group than those in the MP group.

A preoperative single low dose of MP (1 mg/kg) had no effect on immune function but had effective analgesic effects and could reduce the incidence of dizziness and postoperative nausea and vomiting.