Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: The Effects of Corticosteroids, Glucose Control, and Depth-of-Anesthesia on Perioperative Inflammation and Morbidity From Major Non-cardiac Surgery (Dexamethasone, Light Anesthesia and Tight Glucose Control (DeLiT Trial))
Brief Summary: Evidence thus suggests that steroid administration, tight glucose control, and avoidance of deep anesthesia may decrease perioperative morbidity by reducing the inflammatory response to surgery. Using a three-way factorial approach, the investigators thus propose to test the primary hypotheses that major perioperative morbidity is reduced by: 1) low-dose dexamethasone; 2) intensive perioperative glucose control; and 3) lighter anesthesia.

Secondary hypotheses include that each intervention reduces circulating concentrations of the inflammatory marker CRP, and that there is a correlation between C-reactive protein (CRP) and post-operative complications. Anesthetic sensitivity predicts major and minor complications, and delirium Other secondary hypotheses are that each intervention, reduces minor surgical complications, reduces postoperative nausea and vomiting (PONV), reduces postoperative delirium, speeds hospital discharge, improves quality of life (SF-12v2 Health Survey, Christensen's VAS fatigue score), and reduces all-cause one-year mortality.


Options:
A: Arm Label: 8 mg dexamethasone; Type: ACTIVE_COMPARATOR; Interventions: Drug: Dexamethasone | Arm Label: Placebo, saline; Type: PLACEBO_COMPARATOR; Interventions: Drug: Dexamethasone | Arm Label: 40 mg dexamethasone; Type: EXPERIMENTAL; Interventions: Drug: Dexamethasone | Intervention Type: DRUG; Name: Dexamethasone; Assigned to Arm(s): 40 mg dexamethasone, 8 mg dexamethasone, Placebo, saline
B: Arm Label: Multimodal; Type: EXPERIMENTAL; Interventions: Drug: Ibuprofen, Drug: Gabapentin, Drug: Paracetamol | Arm Label: Morphine; Type: ACTIVE_COMPARATOR; Interventions: Drug: Morphine, Drug: Paracetamol | Intervention Type: DRUG; Name: Ibuprofen; Assigned to Arm(s): Multimodal | Intervention Type: DRUG; Name: Gabapentin; Assigned to Arm(s): Multimodal | Intervention Type: DRUG; Name: Morphine; Assigned to Arm(s): Morphine | Intervention Type: DRUG; Name: Paracetamol; Assigned to Arm(s): Morphine, Multimodal
C: Arm Label: A, 1; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo | Arm Label: A, 2; Type: ACTIVE_COMPARATOR; Interventions: Drug: Dexamethason Helvepharm ® | Intervention Type: DRUG; Name: Dexamethason Helvepharm ®; Assigned to Arm(s): A, 2 | Intervention Type: DRUG; Name: Placebo; Assigned to Arm(s): A, 1
D: Arm Label: Intensive Glucose Control, Dexamethasone, light anesthesia; Type: ACTIVE_COMPARATOR; Interventions: Drug: Dexamethasone Sodium Sulfate, Drug: Insulin, Drug: anesthesia management | Arm Label: Intensive Glucose Control, Dexamethasone, Deep anesthesia; Type: ACTIVE_COMPARATOR; Interventions: Drug: Dexamethasone Sodium Sulfate, Drug: Insulin, Other: Anesthesia management -Placebo | Arm Label: Intensive Glucose Control, placebo, Light anesthesia; Type: ACTIVE_COMPARATOR; Interventions: Drug: Dexamethasone Sodium Sulfate, Drug: anesthesia management, Other: Insulin - Placebo | Arm Label: Conventional Glucose Control, Dexamethasone, Light anesthesia; Type: ACTIVE_COMPARATOR; Interventions: Drug: Insulin, Drug: anesthesia management, Other: Dexamethasone - placebo | Arm Label: Intensive Glucose Control, Placebo, Deep anesthesia; Type: ACTIVE_COMPARATOR; Interventions: Drug: Dexamethasone Sodium Sulfate, Other: Insulin - Placebo, Other: Anesthesia management -Placebo | Arm Label: Conventional Glucose Control, Dexamethasone, Deep anesthesia; Type: ACTIVE_COMPARATOR; Interventions: Drug: Insulin, Other: Dexamethasone - placebo, Other: Anesthesia management -Placebo | Arm Label: Conventional Glucose Control, Placebo, Light anesthesia; Type: ACTIVE_COMPARATOR; Interventions: Drug: anesthesia management, Other: Dexamethasone - placebo, Other: Insulin - Placebo | Arm Label: Conventional Glucose Control, Placebo, Deep anesthesia; Type: PLACEBO_COMPARATOR; Interventions: Other: Dexamethasone - placebo, Other: Insulin - Placebo, Other: Anesthesia management -Placebo | Intervention Type: DRUG; Name: Dexamethasone Sodium Sulfate; Assigned to Arm(s): Intensive Glucose Control, Dexamethasone, Deep anesthesia, Intensive Glucose Control, Dexamethasone, light anesthesia, Intensive Glucose Control, Placebo, Deep anesthesia, Intensive Glucose Control, placebo, Light anesthesia | Intervention Type: DRUG; Name: Insulin; Assigned to Arm(s): Conventional Glucose Control, Dexamethasone, Deep anesthesia, Conventional Glucose Control, Dexamethasone, Light anesthesia, Intensive Glucose Control, Dexamethasone, Deep anesthesia, Intensive Glucose Control, Dexamethasone, light anesthesia | Intervention Type: DRUG; Name: anesthesia management; Assigned to Arm(s): Conventional Glucose Control, Dexamethasone, Light anesthesia, Conventional Glucose Control, Placebo, Light anesthesia, Intensive Glucose Control, Dexamethasone, light anesthesia, Intensive Glucose Control, placebo, Light anesthesia | Intervention Type: OTHER; Name: Dexamethasone - placebo; Assigned to Arm(s): Conventional Glucose Control, Dexamethasone, Deep anesthesia, Conventional Glucose Control, Dexamethasone, Light anesthesia, Conventional Glucose Control, Placebo, Deep anesthesia, Conventional Glucose Control, Placebo, Light anesthesia | Intervention Type: OTHER; Name: Insulin - Placebo; Assigned to Arm(s): Conventional Glucose Control, Placebo, Deep anesthesia, Conventional Glucose Control, Placebo, Light anesthesia, Intensive Glucose Control, Placebo, Deep anesthesia, Intensive Glucose Control, placebo, Light anesthesia | Intervention Type: OTHER; Name: Anesthesia management -Placebo; Assigned to Arm(s): Conventional Glucose Control, Dexamethasone, Deep anesthesia, Conventional Glucose Control, Placebo, Deep anesthesia, Intensive Glucose Control, Dexamethasone, Deep anesthesia, Intensive Glucose Control, Placebo, Deep anesthesia

Answer: D