| Perioperative dexamethasone does not affect functional outcome in total hip arthroplasty. | |
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MedLine Citation:
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PMID: 19224304 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Current trends in orthopaedic surgery have explored different forms of adjuvant treatments to minimize postoperative pain and the risk of nausea and vomiting. A small single preoperative dose of dexamethasone, as part of a comprehensive multimodal analgesic regimen in low-risk patients undergoing total hip arthroplasty (THA), provides antiemetic and opioid-sparing effects but the longer-term effects on pain, complications, or function are not known. We therefore asked whether such a routine would affect longer-term pain, complications, or function. Fifty patients undergoing elective primary THA using spinal anesthesia were initially randomized to receive either dexamethasone (40 mg intravenous) or saline placebo. The patients, anesthesiologists, nurses, and research coordinators were blinded to the study arms. The functional outcome was measured using the Harris hip score. Outcomes were assessed 6 weeks and 1 year postoperatively. We observed no difference in resting pain between the two groups at either time period. Both groups had similar functional outcome scores for the total Harris hip score and individual scoring items at each followup interval. There were no wound complications, deep infections, or osteonecrosis in the contralateral hip at 1-year followup. We recommend the addition of a small single preoperative dose of dexamethasone to a comprehensive multimodal analgesic regimen in low-risk patients given its immediate antiemetic and opioid-sparing effects, and absence of subsequent effects. Level of Evidence: Level II, therapeutic study (prospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence. |
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Authors:
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Stephane G Bergeron; Kenneth J Kardash; Olga L Huk; David J Zukor; John Antoniou |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2009-02-18 |
Journal Detail:
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Title: Clinical orthopaedics and related research Volume: 467 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-04-28 Completed Date: 2009-06-05 Revised Date: 2010-09-22 |
Medline Journal Info:
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Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States |
Other Details:
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Languages: eng Pagination: 1463-7 Citation Subset: AIM; IM |
Affiliation:
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Division of Orthopaedic Surgery, Montreal General Hospital, McGill University Health Centre, Montreal, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Analysis of Variance Antiemetics / therapeutic use* Arthroplasty, Replacement, Hip Chi-Square Distribution Dexamethasone / therapeutic use* Female Humans Male Pain Measurement Pain, Postoperative / prevention & control* Postoperative Nausea and Vomiting / prevention & control* Questionnaires Range of Motion, Articular Recovery of Function Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antiemetics; 50-02-2/Dexamethasone |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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