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 .
Effect of high-dose preoperative methylprednisolone on recovery after total hip arthroplasty: a randomized, double-blind, placebo-controlled trial.
BACKGROUND High-dose glucocorticoid may reduce postsurgical pain  and improve recovery . We hypothesized that 125 mg methylprednisolone ( MP ) would reduce time to meet functional discharge criteria after total hip arthroplasty ( THA ) . METHODS Forty-eight patients undergoing unilateral THA under spinal anaesthesia were consecutively included in this r and omized , double-blind , placebo-controlled trial receiving preoperative i.v . MP or saline . All patients received a st and ardized , multimodal analgesic regime with paracetamol , celecoxib , and gabapentin . The primary outcome was time to meet well-defined functional discharge criteria . Secondary outcomes were h and grip strength and endurance , pain , nausea , vomiting , fatigue , sleep quality , and rescue analgesic- , antiemetic- , and hypnotic medicine requirements . The inflammatory response measured by C-reactive protein ( CRP ) and actual length of stay were also registered . Discharge criteria were assessed twice daily ( at 09:00 and 14:00 h ) until discharge . Other outcomes were assessed at 2 , 4 , 6 , 8 , and 24 h after operation , and also in a question naire from postoperative day ( POD ) 1 - 4 . RESULTS Time to meet discharge criteria was [ median ( IQR ) ( 95 % CI ) , MP vs placebo ] : 23.5 ( 23.3 - 23.7 ) ( 17.8 - 43.8 ) vs 23.5 ( 23.0 - 23.8 ) ( 20.0 - 46.8 ) h , the mean difference ( 95 % CI ) being -1.3 ( -4.7 to 2.2 ) h , P=0.65 . Overall pain for the first 24 h after surgery was significantly reduced in the MP vs the placebo group ( P<0.01 ) , as was CRP at 24 h ( P<0.0001 ) . No other between-group differences were observed . No drug-related complications were observed at follow-up on POD30 . CONCLUSIONS MP 125 mg i.v . before surgery added to a multimodal oral analgesic regime did not reduce time to meet functional discharge criteria after THA , but improved analgesia for the first 24
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 .