Meta- analysis showed that high-dose systemic steroid ( dexamethasone > 0.1 mg/kg ) rather than low dose is effective to reduce postoperative nausea and vomiting and postoperative acute pain ( within 24 h ) .
In addition , systemic steroid is associated within faster functional rehabilitation and greater inflammation control .
On the other h and , systemic steroid is associated with a higher level of postoperative serum glucose on the operation day .
Conclusions Our study suggests that by providing lower incidence of postoperative nausea and vomiting and less postoperative acute pain , high-dose systemic steroid plays a critical role in rapid recovery to TKA and THA .
The preliminary results also show the superior possibility of systemic steroid in functional rehabilitation and inflammation control .
Background Perioperative systemic steroid administration for rapid recovery in total knee and hip arthroplasty ( TKA/THA ) is an important and controversial topic .
We conducted this systematic review and meta- analysis to evaluate the overall benefits and harms of perioperative systemic steroid in patients undergoing TKA and THA .
Use of Low-Dose Steroids in Decreasing Cytokine Release During Bilateral Total Knee Replacement
Background : Interleukin 6 ( IL-6 ) , a marker of inflammation , is one of the major cytokines released during joint replacement . In the orthopedic patient population , high levels have been linked to many adverse effects including acute respiratory distress syndrome , postoperative mental status changes , and fever . We looked to assess the efficacy of low-dose steroids on the postinflammatory response as measured by IL-6 in patients undergoing bilateral total knee replacement ( BTKR ) . The role of steroids has never been evaluated before in that setting . Methods : Double-blind , r and omized , placebo-controlled study of 30 patients undergoing BTKR . The study was powered in order to detect at least a 25 % decrease in IL-6 from control . Hydrocortisone ( 100 mg ) or placebo was given at 2 doses 8 hrs apart to the study and control group respectively . Clinical outcome was assessed as well . Results : Levels of IL-6 were 40 % lower in the study group by 10 hrs ( P = 0.0037 ) but were similar to the control group at 24 hrs . Greater hemodynamic stability was noted in the study group with fewer episodes of hypotension postoperatively ( P = 0.031 ) . Range of motion gained on discharge was also greatest in the study group ( P = 0.049 ) . Absence of infection and normal wound healing were noted in all patients . Conclusions : The use of hydrocortisone significantly decreased the inflammatory response in patients undergoing BTKR as measured by IL-6 production . Further studies looking at clinical implication s of such findings in a larger patient population and with a longer course of steroids are warranted
Meta- analysis showed that high-dose systemic steroid ( dexamethasone > 0.1 mg/kg ) rather than low dose is effective to reduce postoperative nausea and vomiting and postoperative acute pain ( within 24 h ) .
In addition , systemic steroid is associated within faster functional rehabilitation and greater inflammation control .
On the other h and , systemic steroid is associated with a higher level of postoperative serum glucose on the operation day .
Conclusions Our study suggests that by providing lower incidence of postoperative nausea and vomiting and less postoperative acute pain , high-dose systemic steroid plays a critical role in rapid recovery to TKA and THA .
The preliminary results also show the superior possibility of systemic steroid in functional rehabilitation and inflammation control .
Background Perioperative systemic steroid administration for rapid recovery in total knee and hip arthroplasty ( TKA/THA ) is an important and controversial topic .
We conducted this systematic review and meta- analysis to evaluate the overall benefits and harms of perioperative systemic steroid in patients undergoing TKA and THA .