Anne Arundel Medical Center, Annapolis, MD.
J Arthroplasty. 2021 Mar;36(3):1009-1012. doi: 10.1016/j.arth.2020.09.015. Epub 2020 Sep 17.
Dexamethasone has been shown to reduce postoperative pain and opioid consumption for total joint arthroplasty patients; however, its impact on patients who received neuraxial anesthesia (NA) is not well described. We examined the impact of perioperative dexamethasone on outcomes for patients undergoing direct anterior approach total hip arthroplasty (THA) under NA.
A retrospective review was conducted for 376 THA patients from a single institution. Univariate analysis was used to compare postoperative outcomes for 164 THA patients receiving dexamethasone compared to 212 who did not receive dexamethasone.
No differences in age, gender, body mass index, or American Society of Anesthesiologists (ASA) Score were observed between the groups. Patients receiving perioperative dexamethasone reported statistically significantly lower postanesthesia care unit (PACU) pain numeric rating scale (Dexamethasone 1.6 vs No dexamethasone 2.3, P = .014) and received lower PACU morphine milligram equivalents (MME) (Dexamethasone 8.57 vs No dexamethasone 11.44, P < .001). Patients receiving dexamethasone had significantly shorter LOS (Dexamethasone 29.40 vs No dexamethasone 35.26 hrs., P < .001).
Perioperative dexamethasone is associated with decreased postoperative pain and narcotic consumption, and shorter length of stay for patients undergoing primary direct anterior approach THA with NA.
地塞米松已被证明可减少全关节置换术患者的术后疼痛和阿片类药物的使用；然而，其对接受脊麻（NA）的患者的影响尚未得到很好的描述。我们研究了围手术期地塞米松对接受直接前路全髋关节置换术（THA）并接受 NA 的患者的影响。
对来自单一机构的 376 例 THA 患者进行了回顾性研究。使用单变量分析比较了接受地塞米松的 164 例 THA 患者与未接受地塞米松的 212 例患者的术后结果。
两组患者的年龄、性别、体重指数或美国麻醉医师协会（ASA）评分无差异。接受围手术期地塞米松的患者报告术后在麻醉后护理病房（PACU）的疼痛数字评分量表（地塞米松 1.6 分 vs 无地塞米松 2.3 分，P=0.014）和在 PACU 中接受的吗啡毫克当量（MME）（地塞米松 8.57 分 vs 无地塞米松 11.44 分，P<0.001）均较低。接受地塞米松的患者 LOS 显著缩短（地塞米松 29.40 小时 vs 无地塞米松 35.26 小时，P<0.001）。
对于接受直接前路 THA 并接受 NA 的患者，围手术期地塞米松与术后疼痛减轻和阿片类药物消耗减少以及住院时间缩短有关。
