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 .
Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: A case study of 325 patients
Background We have developed a multimodal technique for the control of pain  following knee and hip surgery , called " local infiltration analgesia " ( LIA ) . It is based on systematic infiltration of a mixture of ropiva-caine , ketorolac , and adrenaline into the tissues around the surgical field to achieve satisfactory pain control with little physiological disturbance . The technique allows virtually immediate mobilization and earlier discharge from hospital . Patients and methods In this open , nonr and omized case series , we used LIA to manage postoperative pain in all 325 patients presenting to our service from Jan 1 , 2005 to Dec 31,2006 for elective hip resurfacing ( HRA ) , primary total hip replacement ( THR ) , or primary total knee replacement arthroplasty ( TKR ) . We recorded pain scores , mobilization times , and morphine usage for the entire group . Results Pain control was generally satisfactory ( numerical rating scale pain score range 0–3 ) . No morphine was required for postoperative pain control in two-thirds of the patients . Most patients were able to walk with assistance between 5 and 6 h after surgery and independent mobility was achieved 13–22 h after surgery . Orthostatic hypotension , nausea , and vomiting were occasionally associated with st and ing for the first time , but other side effects were unremarkable . 230 ( 71 % ) of the 325 patients were discharged directly home after a single overnight stay in hospital . Interpretation Local infiltration analgesia is simple , practical , safe , and effective for pain management after knee and hip surgery
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 .