Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Effect of Dexamethasone in Combination With Paracetamol and Ibuprofen as Adjuvant, Postoperative Pain After Herniated Disc Surgery
Brief Summary: The analgesic effect of dexamethasone is not well described, but studies have shown that dexamethasone can be a safe part of a multimodal analgesic strategy after surgery. Our purpose is to investigate if dexamethasone in combination with paracetamol and ibuprofen has an increased analgesic effect compared to paracetamol and ibuprofen alone, on postoperative pain after spine surgery. Our hypothesis is that dexamethasone can reduce postoperative pain and reduce opioidconsumption and side effects compared to placebo.


Options:
A: Inclusion Criteria:

* Females
* Ages 18 to 65 years old

Exclusion Criteria:

* Patients who is taking steroid or who had been treated for the gastrointestinal disease
* Patients who have troubles with the kidney or liver
* Patients transferring to the ICU after the surgery
* overfat patients
* Patients who had taken antiemetics within 24 hours before the surgery
B: Inclusion Criteria:

* Scheduled for unilateral, primary total knee arthroplasty
* ASA 1-3
* BMI ≥ 18.0 and ≤ 40.0
* Negative urine HCG pregnancy test and use of anti-conception for women in the fertile age
* Patients who gave their written informed consent to participating in the trial after having fully understood the contents of the protocol and restrictions

Exclusion Criteria:

* Patients who cannot cooperate with the trial
* Concomitant participation in another trial involving medication
* Patients who cannot understand or speak Danish
* Patients with allergy to medication used in the trial
* Patients with daily use of high dose opioid (\> oral morphine 30 mg/day or oxycodone 30 mg/day or tramadol 150 mg/day) or any use of other opioids including methadone and transdermal opioids.
* Patients with at daily use of systemic glucocorticoids
* Contraindications against ibuprofen or paracetamol, for example previous ulcer, known heart failure, known liver failure, or known renal failure (eGRF \< 60 ml/kg/1,73m2), known thrombocytopenia (\<100 bil/l); or against treatment with glucocorticoids.
* Dysregulated diabetes (investigators judgement)
* Patients suffering from alcohol and/or drug abuse - based on the investigator's judgement
C: Inclusion Criteria:

* Patients undergoing lumbar disc surgery in general anaesthesia.
* Patients who have given their written consent to participate and understand the contents of the protocol.
* ASA 1-3.
* BMI \> 18 og \< 40.
* Fertile women need a negative HCG urine test.

Exclusion Criteria:

* Patients who cannot cooperate to the study.
* Patients who do not speak and/or understand Danish.
* Fertile women with a positive HCG urine test.
* Allergy to the drugs used in the trial.
* Alcohol or medicine abuse, assessed by investigator.
* Patients who have had spine surgery before.
* Daily use of strong opioids (morphine, ketobemidone, oxynorm, methadone, fentanyl)
* Daily oral steroid treatment.
D: Inclusion Criteria:

* Patients over or equal to the age of 18 years old who can understand the study protocol and are able to give consent
* Patients with an American Society of Anaesthesiology (ASA) classification 1 to 3
* Patients must have a preoperative oral 24 hour opioid consumption of less than or equal to 30 mg morphine equivalents
* Patients must be able to understand and be able to use patient controlled analgesia
* Patients must be undergoing a primary total knee arthroplasty with neuraxial anesthesia

Exclusion Criteria:

* Patients with a contraindication to neuraxial and/or regional anaesthesia
* Patients with an allergy to local anaesthetics
* Patients who have chronic pain not related to their knee joint
* Patients with chronic opioid use (daily or almost daily use \>3 months)
* Patients with contraindications to dexamethasone (allergy, infection, Insulin dependent Diabetes Mellitus)
* Patients with pre-existing neuropathy
* Patients with hepatic failure
* Patients with renal failure with eGFR\<60
* Patients with allergy to ketorolac or NSAIDs

Answer: C