Perioperative dexamethasone reduces pain after knee replacement

The study seeks to justify complete analgesic 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 Perioperative intravenous to multimodal analgesia in total hip arthroplasty. 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 the frequency of this surgery is increasing, justifying comprehensive analgesic strategies that limit opioids.

“Current evidence did not support the superiority of repeated doses of dexamethasone about single doses of dexamethasone. Therefore, we recommend perioperatively 8-10 mg of dexamethasone to use based on adequate basic analgesia”, they indicate.

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

Key results

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


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

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


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

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

In addition, the dexamethasone group:

Needed less morphine (DM):

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

48 hours (-4.16 mg; p<0.00001).

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

He had shorter hospital stays (DM, -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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