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 .
Perioperative Dexamethasone Does Not Affect Functional Outcome in Total Hip Arthroplasty
Abstract Current trends in orthopaedic surgery have explored different forms of adjuvant treatments to minimize postoperative pain and the risk of nausea and vomiting . A small single preoperative dose of dexamethasone , as part of a comprehensive multimodal analgesic regimen in low-risk patients undergoing total hip arthroplasty ( THA ) , provides antiemetic and opioid-sparing effects but the longer-term effects on pain , complications , or function are not known . We therefore asked whether such a routine would affect longer-term pain , complications , or function . Fifty patients undergoing elective primary THA using spinal anesthesia were initially r and omized to receive either dexamethasone ( 40 mg intravenous ) or saline placebo . The patients , anesthesiologists , nurses , and research coordinators were blinded to the study arms . The functional outcome was measured using the Harris hip score . Outcomes were assessed 6 weeks and 1 year postoperatively . We observed no difference in resting pain between the two groups at either time period . Both groups had similar functional outcome scores for the total Harris hip score and individual scoring items at each followup interval . There were no wound complications , deep infections , or osteonecrosis in the contralateral hip at 1-year followup . We recommend the addition of a small single preoperative dose of dexamethasone to a comprehensive multimodal analgesic regimen in low-risk patients given its immediate antiemetic and opioid-sparing effects , and absence of subsequent effects . Level of Evidence : Level II , therapeutic study ( prospect i ve comparative study ) . See the Guidelines for Authors for a complete description of levels of evidence
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 .