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 .
The effective dose of dexamethasone for antiemesis after major gynecological surgery.
UNLABELLED This double-blind , r and omized , placebo-controlled study evaluated the minimum effective dose of dexamethasone for postoperative antiemesis .  One-hundred fifty women scheduled for major gynecological surgery were r and omly assigned to receive dexamethasone 10 mg ( D10 ) , 5 mg ( D5 ) , 2.5 mg ( D2.5 ) , 1.25 mg ( D1.25 ) , or placebo ( P ) before the induction of general anesthesia . A st and ardized general anesthesia technique was used . Postoperative pain was treated with bolus IV doses of morphine via a patient-controlled analgesia device . Patients were assessed for incidence of vomiting at 4 , 8 , 12 , and 24 h after surgery . A total of 6 , 6 , 8 , 15 , and 19 patients in Groups D10 , D5 , D2.5 , D1.25 , and Group P experienced vomiting at least once within the first postoperative 24 h , respectively . Dexamethasone 10 mg , 5 mg , and 2.5 mg was more effective than dexamethasone 1.25 mg or placebo for antiemesis ( P < 0.05 ) . The difference in antiemetic effect among the 10 mg , 5 mg , and 2.5 mg groups was similar . The results suggest that 2.5 mg is the minimum effective dose of dexamethasone for postoperative antiemesis in patients undergoing general anesthesia for major gynecological surgery . IMPLICATION S Although dexamethasone is effective for antiemesis , major side effects may accompany its perioperative use . To achieve the best antiemesis with the fewest side effects , dexamethasone 10 mg , 5 mg , 2.5 mg , and 1.25 mg were compared with placebo in surgical patients . We found 2.5 mg to be the minimum effective dose without discernible side effects
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 .