Dexamethasone useful in postoperative period of Joint Arthroplasty

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Dexamethasone Reduces Length of Hospitalization and Improves Postoperative Pain and Nausea After Total Joint Arthroplasty: A Prospective, Randomized Controlled Trial

Jeffrey R. Backes, MD, Jared C. Bentley, MD, Joel R. Politi, MD, Bryan T. Chambers, MD

Journal of Arthroplasty, Volume 28, Issue 8, Supplement , Pages 11-17, September 2013

Level 1 Randomised Control Trial

 

 

screen480x480Summary:

  • A level I randomized control trial to assess the influence of peri-operative dexamethasone on post-operative i] analgesia ii] mobility iii] anti emetic effects and iv] the length of stay at the hospital.

Materials and Methods:

  • Patients and interventions: 120 patients undergoing total hip and knee arthroplasty were randomized to 3 groups.
  • I – control group,
  • II – study group 1 were administered 10 mg of iv dexamethasone prior to induction
  • III – study group 2 – received an additional identical dose of iv dexamethasone 24 hours postoperatively.
  • Intravenous dexamethasone was administered in the 2 study groups as part of a multimodal pain regimen, which was otherwise same across 3 groups.

Results:

  • Study group 1 demonstrated significantly better i] pain and nausea scores ii] ambulated longer distances iii] consumed less analgesics and rescue anti-emetic medications and iv] stayed for a shorter period at the hospital compared to the control group (P < 0.05).
  • Study group 2 demonstrated a continuous beneficial effect with patients consuming lesser analgesics and anti-emetic medications on postoperative day 2 and later and had a further reduction in hospital stay compared to study group 1 (P <0.05). The 2nd dose of dexamethasone however had no effect on ambulatory distance.

Conclusion:

  • Addition of iv dexamethasone to a multimodal pain regimen provides better pain and nausea control, enhances mobility and reduces hospital stay. A second identical dose further reduces hospital stay and enhances pain and nausea control.

Submitted by Dr Ashok Sunil Gavaskar

Comments

  1. manuel carrasco says

    hola

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