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Area of Science:

  • Orthopedic Surgery
  • Anesthesiology
  • Pharmacology

Background:

  • Total joint arthroplasty (TJA) is associated with significant pain and postoperative nausea and vomiting (PONV).
  • Intravenous glucocorticoids are explored for their potential to manage these common TJA complications.

Purpose of the Study:

  • To evaluate the efficacy and safety of intravenous glucocorticoids in reducing pain intensity and PONV following TJA.
  • To synthesize evidence from randomized controlled trials (RCTs) on this therapeutic approach.

Main Methods:

  • A comprehensive meta-analysis was conducted, searching major databases for relevant RCTs.
  • Included studies compared intravenous glucocorticoids against placebo or no treatment in TJA patients.
  • Key outcomes assessed included pain scores (VAS), PONV incidence, hospital stay, infection rates, and blood glucose levels.

Main Results:

  • Thirteen RCTs involving 821 patients were analyzed.
  • Intravenous glucocorticoids significantly reduced visual analogue scale (VAS) pain scores at 12, 24, and 48 hours post-surgery.
  • A significant decrease in the occurrence of PONV was observed with intravenous glucocorticoid use.

Conclusions:

  • Intravenous glucocorticoids demonstrate efficacy in alleviating early pain and reducing PONV after TJA.
  • No significant differences were found in hospital stay, infection rates, or postoperative blood glucose levels.
  • High-quality RCTs are recommended to further ascertain the safety profile of glucocorticoids in this context.