Perioperative dexamethasone reduces pain after knee replacement

The study aims to justify comprehensive pain relief strategies that limit opioids.

Dexamethasone is a corticosteroid used in a wide variety of conditions for its anti-inflammatory and immunosuppressive effects. Photo: Shutterstock.

“Our results supported the addition of dexamethasone Intravenous to multimodal intraoperative analgesia in total hip arthroplasty. knee to reduce postoperative pain, opioid consumption and length of hospital stay,” the specialists noted in an article published in the Painphysician Journal.

The study is relevant because the frequency of this operation is increasing, justifying global analgesic strategies that limit opioids.

“Current evidence does not support the superiority of repeated doses of dexamethasone on single doses of dexamethasone. Therefore, we recommend perioperatively 8 to 10 mg of dexamethasone to be used on the basis of adequate baseline analgesia,” they state.

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

Principle results

Compared to the control group, the group with dexamethasone felt less pain based on the 11-point Visual Analogue 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:

Need less morphine (DM):

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

48 hours (-4.16 mg; p

She required rescue analgesia less frequently (relative risk, 0.23; p

He had shorter hospital stays (MD, -0.13 days; p=0.03).

the dexamethasone it did not significantly increase infections, gastrointestinal bleeding, or wound healing complications.

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

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