2017
DOI: 10.1007/s00167-017-4506-x
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Two doses of low-dose perioperative dexamethasone improve the clinical outcome after total knee arthroplasty: a randomized controlled study

Abstract: To study the clinical effect and safety of two doses of low-dose perioperative dexamethasone on pain and recovery after total knee arthroplasty. Methods A total of 108 patients were included in this randomized, double-blinded, placebo-controlled study. They received two doses of 10 mg IV dexamethasone (group Dexa) or IV isotonic saline (group Placebo). The CRP, IL-6 and pain levels, postoperative nausea and vomiting (PONV) incidence, nausea severity, postoperative fatigue, range of motion, length of stay, anal… Show more

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Cited by 80 publications
(102 citation statements)
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“…Furthermore, inflammatory mediators are also involved in nociceptive processing, and some trials have demonstrated that a reduction in the inflammatory response was effective in controlling pain . Corticosteroids have potent anti‐inflammation activities, which have been shown to lower levels of acute‐phase reactants such as CRP and IL‐6 after hip and knee arthroplasty . According to this meta‐analysis, corticosteroids significantly decreased the IL‐6 level in the first 24 hours after operation.…”
Section: Discussionmentioning
confidence: 80%
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“…Furthermore, inflammatory mediators are also involved in nociceptive processing, and some trials have demonstrated that a reduction in the inflammatory response was effective in controlling pain . Corticosteroids have potent anti‐inflammation activities, which have been shown to lower levels of acute‐phase reactants such as CRP and IL‐6 after hip and knee arthroplasty . According to this meta‐analysis, corticosteroids significantly decreased the IL‐6 level in the first 24 hours after operation.…”
Section: Discussionmentioning
confidence: 80%
“…15,35,43,44 Corticosteroids have potent anti-inflammation activities, which have been shown to lower levels of acute-phase reactants such as CRP and IL-6 after hip and knee arthroplasty. [26][27][28]37,40 According to this metaanalysis, corticosteroids significantly decreased the IL-6 level in the first 24 hours after operation. We found that the pain scores both at rest and with activity were also lower during this period, and opioid consumption was less, all of which corroborated the results of previous studies.…”
Section: Discussionmentioning
confidence: 84%
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“…Tranexamic acid (TXA), a synthetic analog of lysine, inhibits fibrinolysis by competitively blocking the lysine binding site of plasminogen, often used for joint replacement to reduce perioperative blood loss, and it has anti‐inflammatory effects. Dexamethasone (DEX), with a strong anti‐inflammatory agent, has been widely used to reduce inflammatory markers, prevent PONV, and relieve postoperative pain and fatigue in various perioperative periods. Many previous randomized controlled trials (RCT) and meta‐analyses have demonstrated the effectiveness of DEX in preventing inflammatory stress, without the disadvantages of the wound and gastrointestinal bleeding complications in THA.…”
Section: Introductionmentioning
confidence: 99%