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Meta-Analysis
. 2018 Mar;97(13):e0100.
doi: 10.1097/MD.0000000000010100.

The efficacy of dexamethasone on pain and recovery after total hip arthroplasty: A systematic review and meta-analysis of randomized controlled trials

Zheng-Rui Fan  1 , Jianxiong Ma, Xin-Long Ma, Ying Wang, Lei Sun, Yan Wang, Ben-Chao Dong
Affiliations
Meta-Analysis

The efficacy of dexamethasone on pain and recovery after total hip arthroplasty: A systematic review and meta-analysis of randomized controlled trials

Zheng-Rui Fan et al. Medicine (Baltimore). 2018 Mar.

Abstract

Background: Total hip arthroplasty (THA) perioperative dexamethasone treatment is still a controversial subject. We write this systematic review and meta-analysis to evaluate the efficacy of dexamethasone on pain and recovery after THA.

Methods: Two researchers searched the relevant studies from Pubmed, Cochrane, and Embase. The research was reported according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Randomized controlled trials (RCTs) were included in our meta-analysis. At the same time, the assessment of the risk of bias was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions version. The pooled data are processed by software RevMan 5.3.

Result: In accordance with inclusion and exclusion, 3 studies with 207 patients were eligible and accepted into this meta-analysis. For RCTs, the risk of bias was evaluated by Cochrane Collaboration tool. Only one study did not have detection bias. Our study demonstrated that the dexamethasone group was more effective than the placebo group in term of visual analogue scale (VAS) score at 24 hours (P < .001), 48 hours (P = .04); opioid consumption (P < .001); length of stay (LOS, P < .001); and postoperative nausea (P = .001).

Conclusion: Dexamethasone not only reduces postoperative pain scores and postoperative opioids consumption within 48 hours, but also reduces postoperative vomiting and effectively reduces LOS. However, we still need large sample size and high quality studies to explore the relationship between complications and dose response to give the final conclusion.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Search results and the selection procedure.
Figure 2
Figure 2
Methodological quality of the randomized controlled trials.
Figure 3
Figure 3
Risk of bias.
Figure 4
Figure 4
VAS score at 24 h after THA. THA = total hip arthroplasty, VAS = visual analogue scale.
Figure 5
Figure 5
VAS score at 48 h after THA. THA = total hip arthroplasty, VAS = visual analogue scale.
Figure 6
Figure 6
Opioid consumption at 48 h after THA. THA = total hip arthroplasty.
Figure 7
Figure 7
Length of hospital stay after THA. THA = total hip arthroplasty.
Figure 8
Figure 8
The incidence of nausea after THA. THA = total hip arthroplasty.
See this image and copyright information in PMC

References

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