What is the optimal regimen for intravenous dexamethasone administration in primary total hip arthroplasty?: A protocol of randomized controlled trial

Medicine (Baltimore). 2020 Sep 4;99(36):e22070. doi: 10.1097/MD.0000000000022070.

Abstract

Background: A number of recent studies have investigated the optimal dosage and timing of dexamethasone in total hip arthroplasty (THA) but have inconsistent findings. Therefore, we designed the randomized controlled research to look for the optimal intravenous dexamethasone dose for the treatment of early postoperative pain after the THA.

Methods: The Declaration of Helsinki principles was followed and the Consolidated Standards of Reporting Trials guidelines for randomized controlled trials was adhered in this study. The First Medical Center in People's Liberation Army General Hospital approved the study (2020-089). After written informed consent was obtained, patients aged between 18 and 80 years with Physical Status I to III of American Society of Anesthesiologists, scheduled for primary unilateral THA, were included in this present work. Randomization is the use of a computer-formed list via a secretary, at a ratio of 1:1:1. The major end points were pain scores at 24 hours, 48 hours, and 72 hours after surgery, with visual analog scale (VAS) utilized at rest, and at 45 degrees passive hip flexion. The secondary outcomes involved the total consumption of morphine, opioid-related side effects, hip range of motion, inflammation markers, and the length of hospital stay.

Results: We assumed that the patients who received 3 doses of dexamethasone intravenously possessed the best postoperative results compared to those who received 1 or 2 doses of the dexamethasone.

Trial registration: This study protocol was registered in Research Registry (researchregistry5864).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Intravenous
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / therapeutic use
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Case-Control Studies
  • Dexamethasone / administration & dosage*
  • Dexamethasone / therapeutic use
  • Humans
  • Inflammation Mediators / metabolism
  • Length of Stay
  • Middle Aged
  • Morphine / adverse effects
  • Narcotics / adverse effects
  • Opioid-Related Disorders / epidemiology
  • Pain, Postoperative / drug therapy*
  • Range of Motion, Articular
  • Visual Analog Scale
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Inflammation Mediators
  • Narcotics
  • Morphine
  • Dexamethasone