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Randomized Controlled Trial
. 2018 Dec 1;19(1):428.
doi: 10.1186/s12891-018-2359-1.

Perioperative multiple low-dose Dexamethasones improves postoperative clinical outcomes after Total knee arthroplasty

Yuangang Wu  1 , Xiaoxi Lu  2   3 , Yimei Ma  2   3 , Yi Zeng  1 , Xianchao Bao  1 , Huazhang Xiong  1 , Bin Shen  4
Affiliations
Randomized Controlled Trial

Perioperative multiple low-dose Dexamethasones improves postoperative clinical outcomes after Total knee arthroplasty

Yuangang Wu et al. BMC Musculoskelet Disord. .

Abstract

Background: The purpose of this study was to investigate the efficacy and safety of multiple low-dose dexamethasones in primary total knee arthroplasty (TKA).

Methods: One hundred fifty patients were equally randomized into 3 groups: Group A (n = 50) received 2 doses of normal saline only; Group B (n = 50) received with 1 dose of intravenous dexamethasone and 1 dose of normal saline; Group C (n = 50) received with 2 doses of intravenous dexamethasone. The clinical outcomes and complications were assessed.

Results: The CRP and IL-6 were significantly lower in Group C and B than Group A at 24, 48, and 72 h postoperatively (P < 0.001 for all). The intensity of postoperative nausea and vomiting (PONV) in Group C was lower than Group A at 24 (P < 0.001, P = 0.002), 48 (P = 0.005, P = 0.041) and 72 h (P = 0.017, P = 0.031) postoperatively and Group B at 24 h (P = 0.027, P = 0.019) postoperatively. Pain were significantly less in Group C than Group A at 24 (P < 0.001), 48 h (P = 0.037) postoperatively and Group B 24 h (P = 0.030) postoperatively. Patients in Group C had better range of motion (ROM) and satisfaction than Group A (P < 0.001, P = 0.002) and B (P = 0.001, P = 0.043). No differences were found in complications.

Conclusions: The administration of 10 mg dexamethasone 1 h before the surgery, and repeated at 6 h postoperatively can significantly reduce the level of postoperative CRP and IL-6 and the incidence of PONV, relieve pain, achieve an additional analgesic effect, and improve the early ROM compared with the other two groups in TKA.

Level of evidence: Therapeutic Level I.

Trial registration: The Chinese Clinical Trial Registry ( ChiCTR1800017036 ). Registered on July 9, 2018.

Keywords: Clinical outcomes; Dexamethasones; Randomized controlled study; Total knee arthroplasty.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Institutional Review Board of West China Hospital (No: 201302007). All participants will be required to provide written informed consent to participate.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
A flow diagram shows the patients assessed and included among 3 groups
Fig. 2
Fig. 2
The level of CRP in all groups. Pre-OP = preoperative, post = postoperative. A significant difference among the 3 groups as calculated with one-way ANOVA. ‡ Significantly different from the Group B. # Significantly different from the Group C
Fig. 3
Fig. 3
The level of IL-6 in all groups. Pre-OP = preoperative, post = postoperative. A significant difference among the 3 groups as calculated with one-way ANOVA. ‡ Significantly different from the Group B. # Significantly different from the Group C
Fig. 4
Fig. 4
The level of pain in all groups. Pre-OP = preoperative, post = postoperative. A significant difference among the 3 groups as calculated with one-way ANOVA. ‡ Significantly different from the Group B. # Significantly different from the Group C
See this image and copyright information in PMC

References

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