Preoperative dexamethasone reduces pain after knee replacement

The study seeks to justify complete analgesic strategies that limit opioids.

Dexamethasone is a corticosteroid used in a variety of conditions for its anti-inflammatory and immunomodulatory effects. Photo: shutterstock.

Our results supported the addition of dexamethasone Perioperative intravenous for multimodal analgesia of the total hip joint. knee To reduce postoperative pain, opioid consumption, and length of hospitalization,” the specialists noted in a paper published in the Painphysician Journal.

The study is relevant because repeating it surgery It is increasing, and justifying systemic analgesic strategies that limit opioids.

“Current evidence does not support the superiority of repeated doses of dexamethasone For single doses of dexamethasone. Therefore, we recommend about 8-10 mg of dexamethasone To use it on the basis of appropriate primary analgesia,” they point out.

Add a single intravenous dose of dexamethasone Perioperative multimodal analgesia was effective and safe in reducing perioperative pain in patients undergoing total hip arthroplasty. knee.

Main results

Compared with the control group, the group with dexamethasone Experiencing less pain based on an 11-point Visual Analog Scale (VAS) score (mean difference [DM] 95% CI [IC 95 %]):

rest:

24 hours (-0.68, -0.87 to -0.49).

48 hours (-0.33, -0.46 to -0.21).

Moving:

24 hours (-0.74, -1.10 to -0.37).

48 hours (-0.46, -0.66 to -0.26).

In addition, the dexamethasone group:

We need less morphine (DM):

24 hours (-2.84 mg, p = 0.02).

48 h (-4.16 mg, p<0.00001).

She required rescue analgesia less frequently (risk ratio, 0.23; P<0.00001).

Duration of hospital stay was shorter (DM, -0.13 days; p = 0.03).

The dexamethasone It did not lead to a significant increase in infections, GI bleeding, or wound healing complications.

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single dose of dexamethasone It was as effective as repeated doses of dexamethasone.