File Download
There are no files associated with this item.
Links for fulltext
(May Require Subscription)
- Publisher Website: 10.1097/EJA.0000000000001372
- Scopus: eid_2-s2.0-85095799943
- PMID: 33105245
- WOS: WOS:000587791800009
- Find via
Supplementary
- Citations:
- Appears in Collections:
Article: Preoperative dexamethasone for pain relief after total knee arthroplasty: a randomised controlled trial
Title | Preoperative dexamethasone for pain relief after total knee arthroplasty: a randomised controlled trial |
---|---|
Authors | |
Issue Date | 2020 |
Publisher | Lippincott Williams & Wilkins. The Journal's web site is located at https://journals.lww.com/ejanaesthesiology/pages/default.aspx |
Citation | European Journal of Anaesthesiology, 2020, v. 37 n. 12, p. 1157-1167 How to Cite? |
Abstract | BACKGROUND:
Corticosteroids can reduce pain but the optimal dose and safety profiles are still uncertain.
OBJECTIVE:
This study aimed to evaluate two different doses of dexamethasone for pain management and their side effects after total knee arthroplasty.
DESIGN:
A prospective randomised, controlled trial.
SETTING:
A tertiary teaching hospital in Hong Kong.
PATIENTS:
One hundred and forty-six patients were randomly allocated to one of three study groups.
INTERVENTIONS:
Before operation, patients in group D8, D16 and P received dexamethasone 8 mg, dexamethasone 16 mg and placebo (0.9% saline), respectively.
MAIN OUTCOME MEASURES:
The primary outcome was postoperative pain score. Secondary outcomes were opioid consumption, physical parameters of the knees and side effects of dexamethasone.
RESULTS:
Compared with placebo, group D16 patients had significantly less pain during maximal active flexion on postoperative day 3 [−1.3 (95% CI, −2.2 to −0.31), P = 0.005]. There was also a significant dose-dependent trend between pain scores and dexamethasone dose (P = 0.002). Compared with placebo, patients in group D16 consumed significantly less opioid [−6.4 mg (95% CI, −11.6 to −1.2), P = 0.025] and had stronger quadriceps power on the first three postoperative days (all P < 0.05). They also had significantly longer walking distance on postoperative day 1 [7.8 m ([95% CI, 0.85 to 14.7), P = 0.023] with less assistance during walking on the first two postoperative days (all P < 0.029) and significantly better quality-of-recovery scores on postoperative day 1 (P = 0.018). There were significant dose-dependent trends between all the above parameters and dexamethasone dose (all P < 0.05). No significant differences were found in the incidence of chronic pain or knee function 3, 6 and 12 months postoperatively.
CONCLUSION:
Dexamethasone 16 mg given before total knee arthroplasty led to a reduction in postoperative pain, less opioid consumption, stronger quadriceps muscle power, better mobilisation and better overall quality-of-recovery after operation. No long-term improvement in reduction in pain and function of the knee was found.
TRIAL REGISTRATION:
ClinicalTrials.gov identifier: NCT02767882. |
Persistent Identifier | http://hdl.handle.net/10722/293248 |
ISSN | 2023 Impact Factor: 4.2 2023 SCImago Journal Rankings: 0.987 |
ISI Accession Number ID |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Chan, TCW | - |
dc.contributor.author | Cheung, CW | - |
dc.contributor.author | Wong, SSC | - |
dc.contributor.author | Chung, YF | - |
dc.contributor.author | Irwin, MG | - |
dc.contributor.author | Chan, PK | - |
dc.contributor.author | Fu, H | - |
dc.contributor.author | Yan, CH | - |
dc.contributor.author | Chiu, KY | - |
dc.date.accessioned | 2020-11-23T08:13:59Z | - |
dc.date.available | 2020-11-23T08:13:59Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | European Journal of Anaesthesiology, 2020, v. 37 n. 12, p. 1157-1167 | - |
dc.identifier.issn | 0265-0215 | - |
dc.identifier.uri | http://hdl.handle.net/10722/293248 | - |
dc.description.abstract | BACKGROUND: Corticosteroids can reduce pain but the optimal dose and safety profiles are still uncertain. OBJECTIVE: This study aimed to evaluate two different doses of dexamethasone for pain management and their side effects after total knee arthroplasty. DESIGN: A prospective randomised, controlled trial. SETTING: A tertiary teaching hospital in Hong Kong. PATIENTS: One hundred and forty-six patients were randomly allocated to one of three study groups. INTERVENTIONS: Before operation, patients in group D8, D16 and P received dexamethasone 8 mg, dexamethasone 16 mg and placebo (0.9% saline), respectively. MAIN OUTCOME MEASURES: The primary outcome was postoperative pain score. Secondary outcomes were opioid consumption, physical parameters of the knees and side effects of dexamethasone. RESULTS: Compared with placebo, group D16 patients had significantly less pain during maximal active flexion on postoperative day 3 [−1.3 (95% CI, −2.2 to −0.31), P = 0.005]. There was also a significant dose-dependent trend between pain scores and dexamethasone dose (P = 0.002). Compared with placebo, patients in group D16 consumed significantly less opioid [−6.4 mg (95% CI, −11.6 to −1.2), P = 0.025] and had stronger quadriceps power on the first three postoperative days (all P < 0.05). They also had significantly longer walking distance on postoperative day 1 [7.8 m ([95% CI, 0.85 to 14.7), P = 0.023] with less assistance during walking on the first two postoperative days (all P < 0.029) and significantly better quality-of-recovery scores on postoperative day 1 (P = 0.018). There were significant dose-dependent trends between all the above parameters and dexamethasone dose (all P < 0.05). No significant differences were found in the incidence of chronic pain or knee function 3, 6 and 12 months postoperatively. CONCLUSION: Dexamethasone 16 mg given before total knee arthroplasty led to a reduction in postoperative pain, less opioid consumption, stronger quadriceps muscle power, better mobilisation and better overall quality-of-recovery after operation. No long-term improvement in reduction in pain and function of the knee was found. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02767882. | - |
dc.language | eng | - |
dc.publisher | Lippincott Williams & Wilkins. The Journal's web site is located at https://journals.lww.com/ejanaesthesiology/pages/default.aspx | - |
dc.relation.ispartof | European Journal of Anaesthesiology | - |
dc.title | Preoperative dexamethasone for pain relief after total knee arthroplasty: a randomised controlled trial | - |
dc.type | Article | - |
dc.identifier.email | Chan, TCW: timkat@hkucc.hku.hk | - |
dc.identifier.email | Cheung, CW: cheucw@hku.hk | - |
dc.identifier.email | Wong, SSC: wongstan@hku.hk | - |
dc.identifier.email | Chung, YF: chungyf@hku.hk | - |
dc.identifier.email | Irwin, MG: mgirwin@hku.hk | - |
dc.identifier.email | Chan, PK: cpk464@hku.hk | - |
dc.identifier.email | Fu, H: drhfu@hku.hk | - |
dc.identifier.email | Yan, CH: yanchoi@hku.hk | - |
dc.identifier.email | Chiu, KY: pkychiu@hkucc.hku.hk | - |
dc.identifier.authority | Cheung, CW=rp00244 | - |
dc.identifier.authority | Wong, SSC=rp01789 | - |
dc.identifier.authority | Irwin, MG=rp00390 | - |
dc.identifier.authority | Yan, CH=rp00303 | - |
dc.identifier.authority | Chiu, KY=rp00379 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1097/EJA.0000000000001372 | - |
dc.identifier.pmid | 33105245 | - |
dc.identifier.scopus | eid_2-s2.0-85095799943 | - |
dc.identifier.hkuros | 319087 | - |
dc.identifier.volume | 37 | - |
dc.identifier.issue | 12 | - |
dc.identifier.spage | 1157 | - |
dc.identifier.epage | 1167 | - |
dc.identifier.isi | WOS:000587791800009 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0265-0215 | - |