Dexamethasone in Pain Control After Total Knee Replacement
Status:
Unknown status
Trial end date:
2017-08-01
Target enrollment:
Participant gender:
Summary
The primary aims of total knee replacement are improvement in functional activities and
reduce pain due to degenerated knee joints. However, there are around 20-30% of patients
would develop significant pain problem despite uncomplicated total knee replacement. It
accounts for major post-operative problems and burdens.
Dexamethasone is glucocorticoid which is associated with anti-inflammatory response. It is
well known to have prophylaxis effect for post-operative nausea and vomiting. Perioperative
single dose of systemic dexamethasone have shown to be useful for reduction in pain and
cumulative opioid consumption. Meta-analysis from De Oliveira et al supports that
dexamethasone (up to 0.2 mg/kg) is a safe and effective multimodal pain strategy after
surgical procedures. However, this dose recommendation is not surgery specific. It is
essential to have more RCTs evaluating the optimal dose of steroid for pain management after
hip and knee surgery.