Intraoperative Blood Pressure Management and Dexamethasone in Lung Cancer Surgery

Last updated: July 29, 2025
Sponsor: Peking University First Hospital
Overall Status: Active - Recruiting

Phase

N/A

Condition

Non-small Cell Lung Cancer

Surgery

Cancer

Treatment

Routine blood presure management

Targeted blood pressure management

Placebo

Clinical Study ID

NCT04209218
2019-234
  • Ages 50-90
  • All Genders

Study Summary

Surgery is the front-line therapy for non-small cell lung cancer (NSCLC) but postoperative complications remains high and patients' long-term outcome is still challenging. In addition to surgery, anesthetic management particularly intraoperative blood pressure management and use of dexamethasone may affect patients' early and long-term outcomes after surgery for NSCLC. This study aims to investigate the impact of intraoperative blood pressure management and dexamethasone administration on early and long-term outcomes in patients undergoing surgery for lung cancer.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Aged >50 years but <90 years.

  • Diagnosed as resectable primary non-small cell lung cancer (stage IA-IIIA) andscheduled for radical surgery with an expected duration of >2 hours.

  • Agree to participate in this study and sign the informed consent.

Exclusion

Exclusion Criteria:

  • Clinical examinations suggest non-resectable lung cancer or patients scheduled for abiopsy surgery.

  • Recurrent or metastatic lung cancer.

  • History of cancer or complicated with cancer in other organs.

  • Long-term exposure to glucocorticoids or other immunosuppressant(s) due toautoimmune disease or organ transplantation.

  • Uncontrolled hypertension (systolic blood pressure >180 mmHg or diastolic bloodpressure >110 mmHg); or requirement of vasopressors to maintain blood pressure.

  • Persistent atrial fibrillation, or acute cardiovascular events (acute coronarysyndrome, stroke, or congestive heart failure) within 3 months.

  • Severe hepatic dysfunction (Child-Pugh C) or renal failure (requirement of renalreplacement therapy).

  • Any other circumstances considered unsuitable for study participation by attendingphysicians or investigators.

Study Design

Total Participants: 1988
Treatment Group(s): 4
Primary Treatment: Routine blood presure management
Phase:
Study Start date:
April 07, 2020
Estimated Completion Date:
December 31, 2029

Study Description

Surgical resection is the main treatment for patients with non-small cell lung cancer (NSCLC) and continuous efforts have been made to evolve surgical strategies and techniques. It has been now been realized that perioperative period is characterized with profound changes and anesthesia management may also affect outcomes of patients after cancer surgery.

Even under well controlled conditions, blood pressure fluctuation frequently occurs during anesthesia and surgery. In previous studies, intraoperative hypotension was associated with increased risk of organ injuries (such as delirium, acute kidney injury, myocardial injury, and stroke) and higher 1-year mortality. Unpublished data showed that intraoperative hypotension was also associated with shortened long-term survival in patients after lung cancer surgery. In a recent trial, individualized intraoperative blood pressure management which avoided intraoperative hypotension decreased the incidence of postoperative organ injury when compared with routine practice. Avoiding intraoperative hypotension may also prolong survival after lung cancer surgery. However, evidences are lacking regarding this topic.

Dexamethasone is frequently used for prevention of postoperative nausea and vomiting. Studies showed that a single low-dose dexamethasone has anti-inflammatory effect and can regulate immune function. It has been shown that perioperative dexamethasone can improve analgesia after surgery. In retrospective studies, perioperative low-dose dexamethasone was associated with less wound infection and improved long-term survival in patients after surgeries for pancreatic and lung cancer. It is hypothesized that intraoperative dexamethasone may reduce postoperative complications and improve long-term survival after lung cancer surgery. Interventional studies are required to confirm this hypothesis.

Connect with a study center

  • Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital

    Beijing, Beijing 100034
    China

    Active - Recruiting

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