Abstract
To determine the effect of Dexamethasone on post-operative pain management in patients undergoing Total Knee Arthroplasty in terms of numerical pain rating scale and total opoid consumption.
This Randomized Controlled Trail (RCT) was conducted for 02 years (7th September 2015 to 6th September 2017). All patients undergoing primary Unilateral Total Knee Replacement (TKR) for Osteoarthritis knee were included in the study. Patients with poor glycemic control (HbA1c > 7.6), Hepatic/Renal failure, corticosteroids/ Immunosuppression drug usage in the last 06 months, known psychiatric illnesses were excluded from the study. All patients were operated by consultant Orthopaedic surgeon under Spinal Anaesthesia and tourniquet control using medial para-patellar approach. Patients were randomly divided into 02 groups, A and B. 79 patients were placed in each group. Group A given 0.1mg/kg body weight Dexamethasone Intravenously 15 minutes prior to surgery and another dose 24 hours post-operatively while in group B (control group) no Dexamethasone given. Post-operative pain using the numerical pain rating scale (NRS) and total narcotics consumed converted to morphine dose equivalent noted immediately post-op, 12-, 24- and 48-hours post-operatively. Data analysis done using SPSS version 23.
A total of 158 patients were included in the study. Of the total, 98 (62.02%) were females and 60 (37.98%) males. Average BMI of patients 26.94 ±3.14 kg/m2. Patients in group A required less post-operative analgesics (p < 0 .01) and had a better numerical pain rating scale score (p < 0 .01) as compared to group B. Pain scores at 24- and 48-hours post-op were significantly less for Dexamethasone group (p < 0 .01).
Use of Dexamethasone per- and post-operatively reduces the pain and amount of analgesics used in patients undergoing TKA.
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