Han Hui, Pan Enhao, Gao Shunzhao, Lu Weijie
Department of Orthopedic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510120, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Mar 15;37(3):365-370. doi: 10.7507/1002-1892.202212058.
To review the application and research progress of dexamethasone in the perioperative period of joint arthroplasty and arthroscopic surgery.
The relevant domestic and foreign literature in recent years was extensively reviewed. The application status and therapeutic effect of dexamethasone in the perioperative period of joint arthroplasty and arthroscopic surgery were summarized.
Studies have shown that intravenous administration of 10-24 mg dexamethasone before or/and within 24-48 hours after operation can reduce the incidence of nausea and vomiting, and reduce the consumption of opioids in patients after hip and knee arthroplasties with high safety. The duration of nerve block during arthroscopic surgery can be prolonged by perineural injecting local anesthetics and 4-8 mg dexamethasone, but the effect of postoperative analgesia is still controversial.
Dexamethasone is widely used in joint and sports medicine. It has the effects of analgesia, antiemetic, and prolonging the time of nerve block. In the future, high-quality clinical studies on the application of dexamethasone in shoulder, elbow, and ankle arthroplasties and arthroscopic surgery are needed, and more attention should be paid to the long-term safety of dexamethasone.
综述地塞米松在关节置换术和关节镜手术围手术期的应用及研究进展。
广泛查阅近年来国内外相关文献，总结地塞米松在关节置换术和关节镜手术围手术期的应用现状及治疗效果。
研究表明，术前或术后24 - 48小时内静脉注射10 - 24毫克地塞米松可降低恶心呕吐的发生率，并减少髋膝关节置换术后患者阿片类药物的用量，安全性高。关节镜手术中，在局部麻醉药中加入4 - 8毫克地塞米松进行神经周围注射可延长神经阻滞时间，但术后镇痛效果仍存在争议。
地塞米松在关节和运动医学中广泛应用，具有镇痛、止吐和延长神经阻滞时间的作用。未来需要开展关于地塞米松在肩、肘和踝关节置换术及关节镜手术中应用的高质量临床研究，同时应更多关注地塞米松的长期安全性。
