Intravenous Dexamethasone Injection Reduces Pain From 12 to 21 Hours After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled Trial

Tammachote, Nattapol; Kanitnate, Supakit

doi:10.1016/j.arth.2019.09.002

Cited by 53 publications

(46 citation statements)

References 33 publications

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“…However, these benefits did not seem to translate into a shorter LOS in this study. One possible explanation for this was that five related studies 14 , 15 , 17 , 23 , 26 had different discharge criteria, which might greatly reduce the clinical significance of this parameter.…”

Section: Discussionmentioning

confidence: 99%

“…Our meta-analysis has several advantages compared with meta-analyses that were previously published. 12 , 13 , 32 First, our study included three additional high-quality RCTs 14 , 15 , 17 and two RCTs 16 , 18 that were written in Chinese and had been excluded from previous meta-analyses, and this would reduce statistical bias and publication bias. Second, we reported the postoperative knee ROM, which is an important parameter for early postoperative recovery and discharge criteria, and it was not included in the previous study.…”

Section: Discussionmentioning

confidence: 99%

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The role of perioperative intravenous low-dose dexamethasone in rapid recovery after total knee arthroplasty: a meta-analysis

Zhuo

et al. 2021

J Int Med Res

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Purpose The purpose of this meta-analysis was to evaluate the overall safety and effectiveness of perioperative intravenous dexamethasone to facilitate postoperative rehabilitation in patients after total knee arthroplasty (TKA). Methods A comprehensive literature search was performed using the Embase, PubMed, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases for relevant randomized controlled trials (RCTs) from inception to 2020. Methodological quality of the trials was assessed using the Cochrane Risk of Bias Tool, and the relevant data were extracted using a predefined data extraction form. Results Ten RCTs with 1100 knees were included. Our study showed a significant reduction in pain using a postoperative pain visual analog scale (VAS) at 24 hours and 48 hours, total opioid consumption at 24 hours and 48 hours, postoperative nausea and vomiting (PONV), active range of motion (ROM) limitation, and passive ROM limitation at 72 hours in dexamethasone-treated groups compared with controls. Conclusion Intravenous low-dose dexamethasone is potentially useful in the perioperative setting for reducing postsurgical immediate ROM limitations, pain, opioid consumption, and PONV. There are no data that directly attribute an increase in postoperative complications to intravenous dexamethasone. More high-quality studies are necessary to draw these conclusions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The role of perioperative intravenous low-dose dexamethasone in rapid recovery after total knee arthroplasty: a meta-analysis

Zhuo

et al. 2021

J Int Med Res

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“…Intravenous acetaminophen has been revealed by meta-analysis as an efficacious adjunct to multimodal analgesia after total joint arthroplasty in terms of pain scores and opioid consumption in the first 72 hours. 13) Tammachote and Kanitnate 14) also revealed that administration of 0.15 mg/ kg of intravenous dexamethasone can significantly relieve pain between 12 hours to 21 hours after TKA and reduce rates of PONV and level of C-reactive protein compared with placebo, but might be associated with transient hyperglycemia. On the other hand, the efficacy of PAI might also be improved by some strategies such as location of injection 15) or adding some adjuvants to the PAI mixture.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Outcomes of Patients Who Were Not Candidates for Additional Nonsteroidal Anti-inflammatory Drugs in a Multimodal Pain Control Regimen for Total Knee Arthroplasty

et al. 2021

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“…Luna et al [ 15 ] indicated that no differences in proportion of patients with moderate to severe pain was found between the corticosteroid and placebo groups at 24 hours or at 48 hours, and no difference between 2 groups in postoperative sensitization. However, Tammachote et al [ 23 ] found that intravenous dexamethasone relieves postoperative pain between 12 hours to 21 hours after TKA and may be a useful adjunct for controlling pain in patients undergoing TKA.…”

Section: Discussionmentioning

confidence: 99%

Administration with corticosteroid relieving pain following total knee arthroplasty

Zhang¹,

Huang

2020

Medicine

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Background: This meta-analysis compares the effectiveness of corticosteroid in relieving pain and inflammation in total knee arthroplasty (TKA) patients. Method: Randomized controlled trials in PubMed (1996 to March 2020), Embase (1996 to March 2020), and the Cochrane Library (CENTRAL, March 2020) compared corticosteroid and placebo in pain in TKA patients were identified by a software and manual searching. The risk of bias and clinical relevance of the included studies were assessed. Sensitivity analysis was performed by omitting each study in turn. The major outcomes of the studies were analyzed by the Stata 12.0. Results: 13 randomized controlled trials that involved 193 patients were included in the present meta-analysis. The results of the study revealed a significantly lower visual analog scale (VAS) score of pain at rest in the corticosteroid group (12 hours: weighted mean difference (WMD)=−1.35, P = .005; 24 hours: WMD=−1.11, P = .000; 48 hours: WMD=−0.31, P = .000; 72 hours: WMD = −0.30, P = .000). And Postoperative VAS scores during mobilization at 12 hours and 24 hours were significantly lower at corticosteroid group when compared with control group (12 hours: WMD = −0.81, P = 0.000; 24 hours: WMD = −1.66, P = .018). Meta-analyses show that administration of corticosteroid can reduce the length of hospital stay, incidence nausea and the C-reactive protein level. While no significant difference was observed in the VAS scores during mobilization at 48 hours and 72 hours and total morphine consumption ( P > .05). Conclusions: Compared to the control group, intraoperative corticosteroid was benefit to the pain management in TKA. However, more high-quality studies are still warranted to further validate our findings, considering there are several limitations in this meta-analysis.

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Intravenous Dexamethasone Injection Reduces Pain From 12 to 21 Hours After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled Trial

Cited by 53 publications

References 33 publications

The role of perioperative intravenous low-dose dexamethasone in rapid recovery after total knee arthroplasty: a meta-analysis

The role of perioperative intravenous low-dose dexamethasone in rapid recovery after total knee arthroplasty: a meta-analysis

Perioperative Outcomes of Patients Who Were Not Candidates for Additional Nonsteroidal Anti-inflammatory Drugs in a Multimodal Pain Control Regimen for Total Knee Arthroplasty

Administration with corticosteroid relieving pain following total knee arthroplasty

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