Samona Jason, Cook Carrie, Krupa Kyle, Swatsell Krystle, Jackson Andrew, Dukes Chase, Martin Sidney
Hurley Medical Center Master of Anesthesia Program, University of Michigan-Flint, Flint, Michigan, USA.
Department of Orthopaedic Surgery, Hurley Medical Center, Flint, Michigan, USA.
Orthop Surg. 2017 Feb;9(1):110-114. doi: 10.1111/os.12313. Epub 2017 Mar 15.
To examine whether the addition of intravenous dexamethasone during total knee arthroplasty (TKA) would be effective at reducing postoperative pain scores and postoperative opioid consumption.
A total of 102 patients undergoing TKA were placed into two groups: 55 subjects received intraoperative dexamethasone 8 mg intravenously (treatment group) and 47 did not receive dexamethasone at any time during the perioperative period. Comparison was made using the 0-10 numeric pain rating scale and the amount of opioids used in each group.
Patients who received dexamethasone required significantly less oral opioids compared to the control group. Pain scores at 24 h post-surgery were significantly less for the dexamethasone group compared to the control group. There was no difference between groups in regards to patient-controlled analgesic dose or pain scores in the post-anesthesia care unit, at 12 or 48 h post-surgery.
A single dose of dexamethasone given intraoperatively significantly decreased oral narcotic consumption and decreased pain scores 24 h postoperatively. Dexamethasone appears to be a safe modality to use to control pain in patients undergoing TKA.
探讨在全膝关节置换术（TKA）期间静脉注射地塞米松是否能有效降低术后疼痛评分及术后阿片类药物的消耗量。
总共102例行TKA的患者被分为两组：55例受试者静脉注射8毫克术中地塞米松（治疗组），47例在围手术期任何时间均未接受地塞米松治疗。使用0至10数字疼痛评分量表以及每组使用的阿片类药物量进行比较。
与对照组相比，接受地塞米松治疗的患者口服阿片类药物的需求量显著减少。与对照组相比，地塞米松组术后24小时的疼痛评分显著更低。在术后12小时或48小时，两组在患者自控镇痛剂量或麻醉后护理单元的疼痛评分方面没有差异。
术中给予单剂量地塞米松可显著减少口服麻醉药物的消耗量，并降低术后24小时的疼痛评分。地塞米松似乎是用于控制TKA患者疼痛的一种安全方式。
