Dexamethasone Attenuate the Perioperative Acute Phase Response for Simultaneous Bilateral Total Hip Arthroplasty

  • Author Footnotes
    1 Wang Xing and JIANG Wenyu are the first authors contributing equally to this manuscript.
    Xing Wang
    Footnotes
    1 Wang Xing and JIANG Wenyu are the first authors contributing equally to this manuscript.
    Affiliations
    Department of Orthopaedic surgery, West China Hospital, Sichuan University, ChengDu, SiChuan Province, People’s Republic of China
    Search for articles by this author
  • Author Footnotes
    1 Wang Xing and JIANG Wenyu are the first authors contributing equally to this manuscript.
    Wenyu Jiang
    Footnotes
    1 Wang Xing and JIANG Wenyu are the first authors contributing equally to this manuscript.
    Affiliations
    Department of Orthopaedic surgery, West China Hospital, Sichuan University, ChengDu, SiChuan Province, People’s Republic of China
    Search for articles by this author
  • Qiang Huang
    Correspondence
    Corresponding Author: Huang Qiang , Department of Orthopaedic surgery, West China Hospital, Sichuan University, Chengdu, 610041. Telephone Number: +86 13060090890 Fax number: +86 028-85422428
    Affiliations
    Department of Orthopaedic surgery, West China Hospital, Sichuan University, ChengDu, SiChuan Province, People’s Republic of China
    Search for articles by this author
  • Fuxing Pei
    Affiliations
    Department of Orthopaedic surgery, West China Hospital, Sichuan University, ChengDu, SiChuan Province, People’s Republic of China
    Search for articles by this author
  • Author Footnotes
    1 Wang Xing and JIANG Wenyu are the first authors contributing equally to this manuscript.
Published:January 11, 2022DOI:https://doi.org/10.1016/j.arth.2022.01.010

      Abstract

      Background

      This study aimed to evaluate the effect of perioperative dexamethasone on acute phase response (APR) after simultaneous bilateral total hip arthroplasty (SimBTHA).

      Methods

      A retrospective case-control study was performed on 177 SimBTHA procedures. The patients were divided into 2 cohorts: patients receiving perioperative dexamethasone and patients in whom no dexamethasone was administered. We observed the effects of perioperative dexamethasone on the APR following SimBTHA by trending C-reactive protein (CRP) and interleukin-6 (IL-6). Besides, the incidence of postoperative nausea and vomiting (PONV), postoperative visual analog scale (VAS) score, use of antiemetic and analgesic rescue and complications were also compared.

      Results

      Compared to the no dexamethasone group, patients receiving dexamethasone yielded a significantly decreased CRP on postoperative day 1, 2 and 3. Such differences of IL-6 were also detected. In addition, the incidence of postoperative nausea and vomiting (PONV), postoperative VAS score, use of antiemetic and analgesic rescue were significantly decreased without increasing the risk of early surgical wound infection and gastrointestinal hemorrhage in patients receiving dexamethasone.

      Conclusion

      The anti-inflammatory effects of dexamethasone can attenuate the APR after SimBTHA as well as decrease the PONV, postoperative VAS score, use of antiemetic and analgesic rescue.

      Keywords

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