Department of Orthopedics, Mount Carmel Health System, Columbus, Ohio.
J Arthroplasty. 2013 Sep;28(8 Suppl):11-7. doi: 10.1016/j.arth.2013.05.041. Epub 2013 Aug 9.
Controlling postoperative pain and nausea after total joint arthroplasty remains an important challenge. We conducted a prospective, randomized controlled trial with 120 patients to determine if the addition of perioperative dexamethasone to a multimodal regimen improves antiemetic and analgesic control, enhances mobility, and shortens hospital length of stay after total hip and knee arthroplasty. Patients administered 10mg of intravenous dexamethasone intraoperatively consumed less daily rescue anti-emetic and analgesic medication, reported superior VAS nausea and pain scores, ambulated further distances, and had a significantly shorter length of stay compared to the control group (P<0.05). A second, 24-hour postoperative dose of 10mg intravenous dexamethasone provided significant additional pain and nausea control and further reduced length of stay (P<0.05). No adverse events were detected with the administration of the intraoperative and/or postoperative dexamethasone.
控制全关节置换术后的疼痛和恶心仍然是一个重要的挑战。我们进行了一项前瞻性、随机对照试验，共纳入 120 例患者，旨在确定围手术期给予地塞米松是否可以改善止吐和镇痛控制、提高活动能力，并缩短全髋关节和膝关节置换术后的住院时间。与对照组相比，术中给予 10mg 静脉内地塞米松的患者每天需要的急救止吐和镇痛药物较少，VAS 恶心和疼痛评分更高，可走动的距离更远，住院时间显著缩短（P<0.05）。术后 24 小时给予第二剂 10mg 静脉内地塞米松可显著进一步控制疼痛和恶心，并进一步缩短住院时间（P<0.05）。术中和/或术后使用地塞米松未发现不良反应。
