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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2014

01-07-2014 | Knee

Effects of dexamethasone on local infiltration analgesia in total knee arthroplasty: a randomized controlled trial

Authors: Masahiko Ikeuchi, Yuko Kamimoto, Masashi Izumi, Kayo Fukunaga, Koji Aso, Natsuki Sugimura, Masataka Yokoyama, Toshikazu Tani

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2014

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Abstract

Purpose

Intraoperative local infiltration analgesia has gained increasing popularity in joint replacement surgery. Because there is considerable variation among drug combinations, analgesic effects of each drug are not well understood. The purpose of this study was to clarify the efficacy of the addition of steroid to local anaesthetics in local infiltration analgesia during total knee arthroplasty.

Methods

Forty patients were randomly allocated to the steroid or control group. Patients in the steroid group received peri-articular injection of ropivacaine, dexamethasone and isepamicin, while dexamethasone was omitted from the analgesic mixture in the control group. Primary outcome was pain severity at rest using 100 mm visual analogue scale.

Results

Pain severity in the steroid group was lower than control group and there were significant differences between groups at post-operative day 1 and 3. Reduction in post-operative pain was associated with a decrease in serum C-reactive protein and interleukin 6 in drainage fluid. The number of patients who were able to perform straight leg raise within post-operative day 2 was 15/20 in the steroid group, which was significantly higher than the control group 5/20.

Conclusion

Adding steroid to local anaesthetics in local infiltration analgesia reduced inflammation both locally and systemically, resulting in significant early pain relief and rapid recovery in total knee arthroplasty.

Level of evidence

Randomized controlled trial, Level I.
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Metadata
Title
Effects of dexamethasone on local infiltration analgesia in total knee arthroplasty: a randomized controlled trial
Authors
Masahiko Ikeuchi
Yuko Kamimoto
Masashi Izumi
Kayo Fukunaga
Koji Aso
Natsuki Sugimura
Masataka Yokoyama
Toshikazu Tani
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2367-5

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