Xie Qiyu, Liao Zhixin, Xu Hong, Yao Wai, Chen Xuming, Wan Xufeng, Wang Duan, Zhou Zongke
West China School of Medicine, Sichuan University, Chengdu, People's Republic of China.
Department of Orthopedic Surgery and Orthopedic Research Institution, West China Hospital, Sichuan University, Chengdu, China.
Orthop Surg. 2025 Sep;17(9):2570-2578. doi: 10.1111/os.70113. Epub 2025 Aug 1.
Aseptic hip revision arthroplasty often results in significant postoperative pain, inflammation, nausea, and vomiting. While perioperative dexamethasone has demonstrated benefits in primary hip arthroplasty, its efficacy and safety in revision procedures remain unclear. This study aims to evaluate the effects of perioperative dexamethasone on postoperative pain, inflammation, postoperative nausea and vomiting (PONV), and safety in aseptic hip revision.
A retrospective cohort study was conducted on 414 patients undergoing aseptic hip revision arthroplasty between 2008 and 2023. Patients were categorized into two groups: those receiving dexamethasone perioperatively (n = 218) and a control group (n = 196). Outcomes included Visual Analog Scale (VAS) pain scores, inflammation markers including C-reactive protein (CRP) and interleukin-6 (IL-6), PONV incidence, analgesic and antiemetic usage, length of stay (LOS), and postoperative complications. Independent samples t-test or Mann-Whitney U test is applied to continuous variables based on normality, while chi-square test or Fisher's exact test is used for categorical variables according to sample size.
The dexamethasone group (average dose: 12.67 mg) exhibited significantly lower VAS scores (p < 0.001) and reduced morphine use on postoperative days (PODs) 1-3. CRP (POD2: 40.60 mg/L vs. 111.66 mg/L) and IL-6 levels (POD1: 31.85 pg/mL vs. 138.28 pg/mL) were significantly lower in the dexamethasone group (both p < 0.001). PONV incidence (28.4% vs. 40.81%) and antiemetic usage were reduced in the dexamethasone group. No significant differences were observed in LOS or postoperative complications between the two groups.
Perioperative low-dose dexamethasone effectively mitigates pain, inflammation, and PONV in aseptic hip revision arthroplasty without increasing the risk of complications.
无菌性髋关节翻修置换术术后常伴有明显疼痛、炎症、恶心和呕吐。虽然围手术期使用地塞米松已在初次髋关节置换术中显示出益处，但其在翻修手术中的疗效和安全性仍不明确。本研究旨在评估围手术期使用地塞米松对无菌性髋关节翻修术后疼痛、炎症、术后恶心呕吐（PONV）及安全性的影响。
对2008年至2023年间接受无菌性髋关节翻修置换术的414例患者进行回顾性队列研究。患者分为两组：围手术期接受地塞米松治疗的患者（n = 218）和对照组（n = 196）。观察指标包括视觉模拟评分（VAS）疼痛评分、炎症标志物如C反应蛋白（CRP）和白细胞介素-6（IL-6）、PONV发生率、镇痛和止吐药物使用情况、住院时间（LOS）以及术后并发症。根据连续性变量的正态性，对连续变量采用独立样本t检验或Mann-Whitney U检验，根据样本量对分类变量采用卡方检验或Fisher精确检验。
地塞米松组（平均剂量：12.67 mg）在术后第1 - 3天的VAS评分显著更低（p < 0.001），吗啡使用量减少。地塞米松组的CRP（术后第2天：40.60 mg/L对111.
66 mg/L）和IL-6水平（术后第1天：31.85 pg/mL对138.28 pg/mL）显著更低（均p < 0.001）。地塞米松组的PONV发生率（28.4%对40.81%）和止吐药物使用量减少。两组在住院时间或术后并发症方面未观察到显著差异。
围手术期低剂量地塞米松可有效减轻无菌性髋关节翻修置换术中的疼痛、炎症和PONV，且不增加并发症风险。
