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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Preoperative intravenous glucocorticoids can decrease acute pain and postoperative nausea and vomiting after total
Qing Yang1, Zhi Zhang, Wenqi Xin
1Department of Anesthesiology, Huaihe Hospital, Henan University, Kaifeng, China.
Medicine
|February 1, 2018
Summary
Preoperative intravenous glucocorticoids effectively reduce acute pain and postoperative nausea and vomiting (PONV) after total hip arthroplasty (THA). Further research is needed to optimize drug selection and safety for this pain management strategy.
Area of Science:
- Anesthesiology and Pain Management
- Orthopedic Surgery
- Pharmacology
Background:
- Postoperative pain and nausea/vomiting (PONV) are common after total hip arthroplasty (THA).
- Preoperative interventions aim to improve patient outcomes and reduce analgesic requirements.
- Glucocorticoids are explored for their anti-inflammatory and antiemetic properties.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials (RCTs).
- To assess the efficacy and safety of preoperative intravenous glucocorticoids for managing acute pain and PONV post-THA.
- To evaluate the impact on postoperative morphine consumption.
Main Methods:
- Systematic review and meta-analysis of published RCTs.
- Searched multiple databases including PubMed, Embase, and CENTRAL.
- Analyzed primary outcomes (pain via VAS, PONV occurrence) and secondary outcome (morphine consumption).
Main Results:
- Preoperative intravenous glucocorticoids significantly reduced acute pain intensity at 4, 24, and 48 hours post-THA (P < .05).
- A significant reduction in PONV occurrence was observed (RR = 0.41, P = .000).
- A notable morphine-sparing effect was found (WMD = -9.36 mg, P = .000).
Conclusions:
- Intravenous glucocorticoids are effective in decreasing early pain intensity and PONV following THA.
- Current evidence is limited by a low number of studies and variability in dosing.
- High-quality RCTs are required to determine optimal drug regimens and confirm safety.
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