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 Effect of Perioperative Corticosteroids in Total Hip Arthroplasty: A Prospective Double-Blind Placebo Controlled Pilot Study.
BACKGROUND Surgery produces a rapid rise in interleukin 6 ( IL-6 ) which may increase the risk of deep vein thrombosis and medical complications . Perioperative corticosteroids suppress IL-6 release in patients undergoing total knee arthroplasty . This study evaluates the effects of a perioperative corticosteroid regimen on IL-6 formation , thrombogenesis , fibrinolysis , and clinical outcomes in patients undergoing unilateral , uncemented , total hip arthroplasty . METHODS Twenty-seven patients ( 14 placebo and 13 study ) were enrolled in this r and omized , double-blind , placebo-controlled trial . The study group received 20 mg of prednisone orally followed by 2 doses of intravenous hydrocortisone , each 8 hours apart . Blood was drawn at several time points for IL-6 , prothrombin fragment 1.2 , and plasmin-alpha-2-antiplasmin complex , a marker of fibrinolysis . In-hospital visual analog pain ( visual analog scale ) scores , patient-controlled analgesia use , and ability to climb stairs were recorded . RESULTS Mean serum IL-6 levels at 6 and 24 hours postoperatively were significantly lower for the study group , whereas serum prothrombin fragment 1.2 and plasmin-alpha-2-antiplasmin were not statistically different at any study time point . Average pain scores were similar ( P > .05 ) , but study group experience less severe pain ( P < .01 ) and less patient-controlled analgesia ( P = .02 ) . At 3 months , 4 patients in the placebo and 1 patient in the study group had difficulty going up and down staircases ( P = .08 ) . CONCLUSION The use of corticosteroids was associated with a statistically significant decrease in IL-6 at 6 and 24 hours postoperatively but did not affect thrombogenic markers . The study group had improved postoperative analgesia and a trend toward improved functional outcome at 3 months postoperatively
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 .