March 02, 2020
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Dexamethasone given intravenously may reduce pain after TKA

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Nattapol Tammachote headshot
Nattapol Tammachote

Published results showed use of IV dexamethasone may be a useful adjunct for controlling pain in patients undergoing total knee arthroplasty.

Nattapol Tammachote, MD, MSc, and colleagues randomly assigned 100 patients who underwent unilateral TKA to receive either 0.15 mg/kg of IV dexamethasone (n=50) or saline placebo (n=50). Researchers considered pain level determined by VAS and the amount of morphine consumption 48 hours or less postoperatively as the primary outcomes, while secondary outcomes included rates of nausea and vomiting, C-reactive protein concentrations and functional outcomes.

At 12, 15, 18 and 21 hours postoperatively, results showed a significantly lower mean VAS score both at rest and during motion in the dexamethasone group. Researchers found a mean difference of –11 points and –15 points in pain at rest and pain during motion, respectively, at 21 hours postoperatively. According to results, 58% of patients in the dexamethasone group experienced nausea and vomiting vs. 84% of patients in the saline placebo group. Patients in the dexamethasone group also had lower levels of mean C-reactive protein, researchers found. At 3-month follow-up, researchers noted no significant differences in mean morphine consumption by 48 hours, modified WOMAC osteoarthritis index scores and range of motion of the knee between the two groups.

“Dexamethasone had not only an antiemetic effect, but it also had an analgesic effect to control pain after TKA for nearly a day,” Tammachote told Healio Orthopedics. “This drug is a good option to be used to control pain after TKA ,especially in patients who had kidney disease.” – by Casey Tingle

 

Disclosure: Tammachote reports no relevant financial disclosures.

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