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The AAHKS Clinical Research Award: Oral Dexamethasone Following Total Knee Arthroplasty: A Double-Blind, Randomized Controlled Trial.

التفاصيل البيبلوغرافية
العنوان: The AAHKS Clinical Research Award: Oral Dexamethasone Following Total Knee Arthroplasty: A Double-Blind, Randomized Controlled Trial.
المؤلفون: Shaw JH; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan., Wesemann LD; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan., Banka TR; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan., North WT; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan., Charters MA; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan., Davis JJ; Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan.
المصدر: The Journal of arthroplasty [J Arthroplasty] 2023 Jul; Vol. 38 (7 Suppl 2), pp. S15-S20. Date of Electronic Publication: 2023 Apr 25.
نوع المنشور: Randomized Controlled Trial; Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE
أسماء مطبوعة: Publication: New Brunswick, NJ : Taylor and Francis
Original Publication: [New York, NY : Churchill Livingstone, c1986-
مواضيع طبية MeSH: Analgesics, Opioid*/therapeutic use , Arthroplasty, Replacement, Knee*/adverse effects, Humans ; Dexamethasone/therapeutic use ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control ; Pain, Postoperative/etiology ; Vomiting/complications ; Vomiting/drug therapy ; Nausea ; Double-Blind Method
مستخلص: Background: Intravenous dexamethasone has been shown to reduce pain in total joint arthroplasty. This double-blind, randomized, placebo-controlled trial investigated the postoperative effects and safety of oral dexamethasone as a potential augment to multimodal pain management in outpatient knee arthroplasty.
Methods: The authors prospectively randomized 109 consecutive patients undergoing primary total knee arthroplasty. Patients assigned to Group A (57 patients) received 4 mg of dexamethasone by mouth twice per day starting postoperative day (POD) 1 for 4 days and those assigned to Group B received placebo capsules. All healthcare professionals and patients were blinded to group allocation. The primary outcome was defined as postoperative pain scores. Secondary outcomes included 90-day postoperative complications, nausea and vomiting, daily opioid usage, assistance for ambulation, difficulty sleeping, and early patient reported outcomes. Demographics were similar between groups.
Results: The patients who received dexamethasone had a statistically significant decrease in VAS scores when averaging POD 1 to 4 (P = .01). The average VAS scores among individual days were significantly lower with dexamethasone on POD 2, 3, and 4. While taking dexamethasone, morning and mid-day VAS scores were significantly lower. There was no difference between the groups with opioid use, nausea or vomiting, 90-day complications, ability to walk with/without assistance, difficulty sleeping, and early patient reported outcomes.
Conclusion: This double-blind, randomized, placebo-controlled trial demonstrated that oral dexamethasone following primary total knee arthroplasty can reduce postoperative pain. This may be a beneficial option in ambulatory surgery where intravenous limitations exist, but larger series are needed to further evaluate the safety profile in this population.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: TKA; ambulatory surgery; dexamethasone; multimodal pain control; postoperative pain protocol; total knee arthroplasty
المشرفين على المادة: 0 (Analgesics, Opioid)
7S5I7G3JQL (Dexamethasone)
تواريخ الأحداث: Date Created: 20230427 Date Completed: 20230725 Latest Revision: 20230725
رمز التحديث: 20231215
DOI: 10.1016/j.arth.2023.04.046
PMID: 37105325
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-8406
DOI:10.1016/j.arth.2023.04.046