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 .
Effects of steroids on thrombogenic markers in patients undergoing unilateral total knee arthroplasty: a prospective, double-blind, randomized controlled trial.
Venous thromboembolism ( VTE ) remains an important complication after total knee arthroplasty ( TKA ) . Systemic thrombin generation starts perioperatively . Inflammation , characterized by a rise in interleukin-6 ( IL6 ) , initiates the coagulation cascade , but low-dose steroids can reduce post-TKA IL6 levels . This double-blinded , r and omized , placebo-controlled study enrolled 30 patients undergoing unilateral TKA to assess the effect of perioperative steroids on serum prothrombin fragment ( PF1.2 ) , a marker of thrombin generation , and plasmin-alpha-2-antiplasmin complex ( PAP ) , a marker of fibrinolysis . Study patients received 100 mg of intravenous hydrocortisone 2 h prior to surgery , and controls received normal saline . Blood sample s , drawn pre-incision and at 4 h post tourniquet release , were assayed for PF1.2 and PAP . The study group had significantly lower mean PF1.2 at 4 h compared to controls ( 616 ± 358 pMol/L vs. 936 ± 332 pMol/L , p = 0.037 ) . The mean rise in PF1.2 in the control group was significantly greater compared to the study group ( 672 ± 173 pMol/L vs. 350 ± 211 pMol/L , p < 0.001 ) . Mean PAP was higher in the study group at 4 h ( 1639 ± 823 µg/L vs. 1087 ± 536 µg/L ) , but did not reach statistical significance ( p = 0.07 ) . These results may have clinical implication s in terms of postoperative VTE risk and management
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 .