American Shoulder and Elbow Surgeons Annual Meeting

American Shoulder and Elbow Surgeons Annual Meeting

Perspective from Howard Routman, DO, FAOAO
Source:

Klag EA, et al. Dexamethasone improves postoperative pain and nausea after total shoulder arthroplasty: A prospective, randomized controlled trial. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 2-3, 2020 (virtual meeting).

Disclosures: Muh reports she is a board or committee member for the American Orthopaedic Association; is a paid consultant for DePuy, Exactech Inc. and FX Shoulder; and receives research support from Smith & Nephew.
November 05, 2020
1 min read
Save

Dexamethasone decreased opioid use, improved pain after shoulder arthroplasty

Perspective from Howard Routman, DO, FAOAO
Source:

Klag EA, et al. Dexamethasone improves postoperative pain and nausea after total shoulder arthroplasty: A prospective, randomized controlled trial. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 2-3, 2020 (virtual meeting).

Disclosures: Muh reports she is a board or committee member for the American Orthopaedic Association; is a paid consultant for DePuy, Exactech Inc. and FX Shoulder; and receives research support from Smith & Nephew.
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Use of dexamethasone decreased anti-emetic and opioid use and improved pain control in patients undergoing shoulder arthroplasty, according to results presented at the American Shoulder and Elbow Surgeons Annual Meeting.

Stephanie J. Muh, MD, and colleagues randomly assigned 91 patients undergoing shoulder arthroplasty to receive either 10 mg of IV dexamethasone within 90 minutes of surgery (n=47) or no dexamethasone (n=45). Muh noted all patients received a standard postoperative multimodal pain regimen and 4 mg of ondansetron for nausea and vomiting as needed.

“Our primary outcome was 24-hour VAS scores, morphine equivalent use and inpatient anti-emetic use,” Muh said in her presentation. “Secondary outcomes included patient-reported postoperative nausea, length of hospital stay and complications.”

Patients in the dexamethasone group used significantly less ondansetron for postoperative nausea during the first 24 hours, according to Muh. She added patients in the dexamethasone group had a significant decrease in VAS scores at all time points.

“Morphine equivalent use was significantly lower in the dexamethasone group compared to controls at 12 and 16 hours, as well as 16 to 20 hours,” Muh said. “When averaged over the first 24 hours, morphine equivalent was also significantly lower in the dexamethasone group.”

Although the dexamethasone group had a higher preoperative glucose, Muh noted no statistically significant difference between the groups. The dexamethasone group also did not have significant glucose elevation postoperatively, Muh said.

“There was no significant difference in the length of hospital stay and follow-up, including 3 to 18 months, showed there were two infections, one in each group, as well as two reoperations, one in each group,” Muh said.