The Efficacy and Safety of Two Low-Dose Peri-Operative Dexamethasone in Total Hip Arthroplasty: A Single-Center Randomized Controlled Trial

Objective To evaluate the efficacy and safety of two low-dose dexamethasone in the perioperative period of total hip arthroplasty (THA) with a single-center randomized controlled trial.Method 98 patients who underwent THA received two low-dose (10 mg) IV-dexamethasone (group dexa) or IV- isotonic saline group (The placebo).The post-operative day 24 h,48 h,72 h c reactive protein (CRP) and interleukin-6(IL-6), the pain VAS scores at rest and mobilization, the incidence of postoperative nausea and vomiting (PONV), nausea VAS score, postoperative fatigue rating and analgesia and antiemetic, the postoperative lengh of stay (PLOS), wound problems and complications were recorded and compared.Results The inflammatory markers (CRP, IL - 6) level postoperative 24,48,72 hours in dexa group of was lower than the placebo group (P<0.05).The 24 hours of rest and dynamic pain VAS score in dexa group was lower than those in blank group (P<0.05).The incidence of PONV, nausea VAS score, fatigue ICFS score in dexa group was lower than the blank group (P<0.05) and the dosage of analgesic and antiemetic were decreased significantly (P<0.05).In addition, the PLOS of dexa group was shorter than the blank group (P< 0.05).There was no significant difference in perioperative complications between the two groups (P> 0.05).Conclusion The application of two low-dose dexamethasone in the perioperative period of THA can effectively reduce the postoperative CRP and IL-6 levels, reduce pain, nausea, postoperative fatigue and the use of opioid analgesics, shorten the PLOS, without increasing the risk of incision infection or gastrointestinal hemorrhage.