Perioperative Dexamethasone Split Between Two Doses Further Reduced Early Postoperative Nausea and Vomiting Than Single-Dose Dexamethasone: A Randomized Blinded Placebo-Controlled Trial
We investigated whether two doses of dexamethasone are more effective than a single dose in reducing early postoperative nausea and vomiting (PONV) during total knee arthroplasty (TKA). A total of 150 patients between June 2021 and June 2022 were randomized into 3 groups: two doses of normal saline...
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| Veröffentlicht in: | The Journal of arthroplasty 2024-12, Vol.39 (12), p.2954-2960 |
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| creator | Chen, Yancheng Niu, Dawei Wang, Yinyin Zhao, Tianlei Xin, Wei Qian, Qirong Fu, Peiliang |
| description | We investigated whether two doses of dexamethasone are more effective than a single dose in reducing early postoperative nausea and vomiting (PONV) during total knee arthroplasty (TKA).
A total of 150 patients between June 2021 and June 2022 were randomized into 3 groups: two doses of normal saline (group A), a single dose of 10 mg dexamethasone before surgery and normal saline after surgery (group B), and two doses of 5 mg dexamethasone during the perioperative period (group C). Primary outcomes were incidences and severity of PONV within 24 hours after surgery, the number and consumption of patients requiring morphine and metoclopramine, and visual analog scale scores for nausea and vomiting at 2, 4, 6, and 24 hours after surgery. Blood glucose levels on days 1, 2, and 3 after operation and incidences of surgical site infection (SSI) as well as gastrointestinal bleeding (GIB) within 45 days after operation were compared.
Within 24 hours after operation, the number and consumption of patients requiring morphine and metoclopramide in groups B and C were significantly lower than those in group A. Incidences and severity of PONV in groups B and C were significantly lower than those in group A. And these differences between groups B and C were significant. At 2, 4, 6, and 24 hours after operation, there were significant differences in visual analog scale scores of PONV between groups A and B, A and C, as well as B and C. On postoperative days 1, 2, and 3, there were no significant differences in blood glucose levels among the groups, and there were no incidences of SSI or GIB in any group within 45 days after operation.
Dexamethasone significantly reduces PONV within 24 hours after TKA, does not result in significant changes in postoperative blood glucose levels, and does not increase the risk of SSI or GIB, particularly on group C.
ChiCTR2400088512.
Chinese Clinical Trial Registry (ChiCTR).
www.chictr.org.cn. |
| doi_str_mv | 10.1016/j.arth.2024.07.029 |
| format | Article |
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A total of 150 patients between June 2021 and June 2022 were randomized into 3 groups: two doses of normal saline (group A), a single dose of 10 mg dexamethasone before surgery and normal saline after surgery (group B), and two doses of 5 mg dexamethasone during the perioperative period (group C). Primary outcomes were incidences and severity of PONV within 24 hours after surgery, the number and consumption of patients requiring morphine and metoclopramine, and visual analog scale scores for nausea and vomiting at 2, 4, 6, and 24 hours after surgery. Blood glucose levels on days 1, 2, and 3 after operation and incidences of surgical site infection (SSI) as well as gastrointestinal bleeding (GIB) within 45 days after operation were compared.
Within 24 hours after operation, the number and consumption of patients requiring morphine and metoclopramide in groups B and C were significantly lower than those in group A. Incidences and severity of PONV in groups B and C were significantly lower than those in group A. And these differences between groups B and C were significant. At 2, 4, 6, and 24 hours after operation, there were significant differences in visual analog scale scores of PONV between groups A and B, A and C, as well as B and C. On postoperative days 1, 2, and 3, there were no significant differences in blood glucose levels among the groups, and there were no incidences of SSI or GIB in any group within 45 days after operation.
Dexamethasone significantly reduces PONV within 24 hours after TKA, does not result in significant changes in postoperative blood glucose levels, and does not increase the risk of SSI or GIB, particularly on group C.
ChiCTR2400088512.
Chinese Clinical Trial Registry (ChiCTR).
www.chictr.org.cn.</description><identifier>ISSN: 0883-5403</identifier><identifier>ISSN: 1532-8406</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2024.07.029</identifier><identifier>PMID: 39053664</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Antiemetics - administration & dosage ; Antiemetics - therapeutic use ; Arthroplasty, Replacement, Knee - adverse effects ; dexamethasone ; Dexamethasone - administration & dosage ; Dexamethasone - adverse effects ; Double-Blind Method ; Female ; Humans ; Male ; Metoclopramide - administration & dosage ; Middle Aged ; Morphine - administration & dosage ; Morphine - adverse effects ; perioperative period ; postoperative nausea and vomiting (PONV) ; Postoperative Nausea and Vomiting - epidemiology ; Postoperative Nausea and Vomiting - etiology ; Postoperative Nausea and Vomiting - prevention & control ; randomized controlled trial ; total knee arthroplasty (TKA)</subject><ispartof>The Journal of arthroplasty, 2024-12, Vol.39 (12), p.2954-2960</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c237t-bd391fdf7153446927871567831318adc909d6d731b6bdd7a6bd43d63fcd69873</cites><orcidid>0009-0005-5203-2279</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0883540324007526$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39053664$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Yancheng</creatorcontrib><creatorcontrib>Niu, Dawei</creatorcontrib><creatorcontrib>Wang, Yinyin</creatorcontrib><creatorcontrib>Zhao, Tianlei</creatorcontrib><creatorcontrib>Xin, Wei</creatorcontrib><creatorcontrib>Qian, Qirong</creatorcontrib><creatorcontrib>Fu, Peiliang</creatorcontrib><title>Perioperative Dexamethasone Split Between Two Doses Further Reduced Early Postoperative Nausea and Vomiting Than Single-Dose Dexamethasone: A Randomized Blinded Placebo-Controlled Trial</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>We investigated whether two doses of dexamethasone are more effective than a single dose in reducing early postoperative nausea and vomiting (PONV) during total knee arthroplasty (TKA).
A total of 150 patients between June 2021 and June 2022 were randomized into 3 groups: two doses of normal saline (group A), a single dose of 10 mg dexamethasone before surgery and normal saline after surgery (group B), and two doses of 5 mg dexamethasone during the perioperative period (group C). Primary outcomes were incidences and severity of PONV within 24 hours after surgery, the number and consumption of patients requiring morphine and metoclopramine, and visual analog scale scores for nausea and vomiting at 2, 4, 6, and 24 hours after surgery. Blood glucose levels on days 1, 2, and 3 after operation and incidences of surgical site infection (SSI) as well as gastrointestinal bleeding (GIB) within 45 days after operation were compared.
Within 24 hours after operation, the number and consumption of patients requiring morphine and metoclopramide in groups B and C were significantly lower than those in group A. Incidences and severity of PONV in groups B and C were significantly lower than those in group A. And these differences between groups B and C were significant. At 2, 4, 6, and 24 hours after operation, there were significant differences in visual analog scale scores of PONV between groups A and B, A and C, as well as B and C. On postoperative days 1, 2, and 3, there were no significant differences in blood glucose levels among the groups, and there were no incidences of SSI or GIB in any group within 45 days after operation.
Dexamethasone significantly reduces PONV within 24 hours after TKA, does not result in significant changes in postoperative blood glucose levels, and does not increase the risk of SSI or GIB, particularly on group C.
ChiCTR2400088512.
Chinese Clinical Trial Registry (ChiCTR).
www.chictr.org.cn.</description><subject>Aged</subject><subject>Antiemetics - administration & dosage</subject><subject>Antiemetics - therapeutic use</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>dexamethasone</subject><subject>Dexamethasone - administration & dosage</subject><subject>Dexamethasone - adverse effects</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Metoclopramide - administration & dosage</subject><subject>Middle Aged</subject><subject>Morphine - administration & dosage</subject><subject>Morphine - adverse effects</subject><subject>perioperative period</subject><subject>postoperative nausea and vomiting (PONV)</subject><subject>Postoperative Nausea and Vomiting - epidemiology</subject><subject>Postoperative Nausea and Vomiting - etiology</subject><subject>Postoperative Nausea and Vomiting - prevention & control</subject><subject>randomized controlled trial</subject><subject>total knee arthroplasty (TKA)</subject><issn>0883-5403</issn><issn>1532-8406</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EokvhBTggH7kk2HFiJ4hLu20BqYJVu3C1HHvCeuXEW9tpKW_G2-HVFhAXLh7L-uYbeX6EXlJSUkL5m22pQtqUFanqkoiSVN0jtKANq4q2JvwxWpC2ZUVTE3aEnsW4JYTSpqmfoiPWkYZxXi_QzxUE63cQVLK3gM_guxohbVT0E-DrnbMJn0K6A5jw-s7jMx8h4os5z4WAr8DMGgw-V8Hd45WP6a_pk5ojKKwmg7_60SY7fcPrjZrwdb45KPamf8e9xSf4KvOZ_pGlp85OJteVUxp6Xyz9lIJ3Lj-tg1XuOXoyKBfhxUM9Rl8uztfLD8Xl5_cflyeXha6YSEVvWEcHM4i8mLrmXSXafOWiZZTRVhndkc5wIxjteW-MUPmsmeFs0IZ3rWDH6PXBuwv-ZoaY5GijBufUBH6OkpG2FoJyRjJaHVAdfIwBBrkLdlThXlIi95HJrdxHJveRSSJkjiw3vXrwz_0I5k_L74wy8O4AQP7lrYUgo7Yw5cXbADpJ4-3__L8Ab22rAg</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Chen, Yancheng</creator><creator>Niu, Dawei</creator><creator>Wang, Yinyin</creator><creator>Zhao, Tianlei</creator><creator>Xin, Wei</creator><creator>Qian, Qirong</creator><creator>Fu, Peiliang</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0005-5203-2279</orcidid></search><sort><creationdate>202412</creationdate><title>Perioperative Dexamethasone Split Between Two Doses Further Reduced Early Postoperative Nausea and Vomiting Than Single-Dose Dexamethasone: A Randomized Blinded Placebo-Controlled Trial</title><author>Chen, Yancheng ; Niu, Dawei ; Wang, Yinyin ; Zhao, Tianlei ; Xin, Wei ; Qian, Qirong ; Fu, Peiliang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c237t-bd391fdf7153446927871567831318adc909d6d731b6bdd7a6bd43d63fcd69873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Antiemetics - administration & dosage</topic><topic>Antiemetics - therapeutic use</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>dexamethasone</topic><topic>Dexamethasone - administration & dosage</topic><topic>Dexamethasone - adverse effects</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Metoclopramide - administration & dosage</topic><topic>Middle Aged</topic><topic>Morphine - administration & dosage</topic><topic>Morphine - adverse effects</topic><topic>perioperative period</topic><topic>postoperative nausea and vomiting (PONV)</topic><topic>Postoperative Nausea and Vomiting - epidemiology</topic><topic>Postoperative Nausea and Vomiting - etiology</topic><topic>Postoperative Nausea and Vomiting - prevention & control</topic><topic>randomized controlled trial</topic><topic>total knee arthroplasty (TKA)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Yancheng</creatorcontrib><creatorcontrib>Niu, Dawei</creatorcontrib><creatorcontrib>Wang, Yinyin</creatorcontrib><creatorcontrib>Zhao, Tianlei</creatorcontrib><creatorcontrib>Xin, Wei</creatorcontrib><creatorcontrib>Qian, Qirong</creatorcontrib><creatorcontrib>Fu, Peiliang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Yancheng</au><au>Niu, Dawei</au><au>Wang, Yinyin</au><au>Zhao, Tianlei</au><au>Xin, Wei</au><au>Qian, Qirong</au><au>Fu, Peiliang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perioperative Dexamethasone Split Between Two Doses Further Reduced Early Postoperative Nausea and Vomiting Than Single-Dose Dexamethasone: A Randomized Blinded Placebo-Controlled Trial</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2024-12</date><risdate>2024</risdate><volume>39</volume><issue>12</issue><spage>2954</spage><epage>2960</epage><pages>2954-2960</pages><issn>0883-5403</issn><issn>1532-8406</issn><eissn>1532-8406</eissn><abstract>We investigated whether two doses of dexamethasone are more effective than a single dose in reducing early postoperative nausea and vomiting (PONV) during total knee arthroplasty (TKA).
A total of 150 patients between June 2021 and June 2022 were randomized into 3 groups: two doses of normal saline (group A), a single dose of 10 mg dexamethasone before surgery and normal saline after surgery (group B), and two doses of 5 mg dexamethasone during the perioperative period (group C). Primary outcomes were incidences and severity of PONV within 24 hours after surgery, the number and consumption of patients requiring morphine and metoclopramine, and visual analog scale scores for nausea and vomiting at 2, 4, 6, and 24 hours after surgery. Blood glucose levels on days 1, 2, and 3 after operation and incidences of surgical site infection (SSI) as well as gastrointestinal bleeding (GIB) within 45 days after operation were compared.
Within 24 hours after operation, the number and consumption of patients requiring morphine and metoclopramide in groups B and C were significantly lower than those in group A. Incidences and severity of PONV in groups B and C were significantly lower than those in group A. And these differences between groups B and C were significant. At 2, 4, 6, and 24 hours after operation, there were significant differences in visual analog scale scores of PONV between groups A and B, A and C, as well as B and C. On postoperative days 1, 2, and 3, there were no significant differences in blood glucose levels among the groups, and there were no incidences of SSI or GIB in any group within 45 days after operation.
Dexamethasone significantly reduces PONV within 24 hours after TKA, does not result in significant changes in postoperative blood glucose levels, and does not increase the risk of SSI or GIB, particularly on group C.
ChiCTR2400088512.
Chinese Clinical Trial Registry (ChiCTR).
www.chictr.org.cn.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39053664</pmid><doi>10.1016/j.arth.2024.07.029</doi><tpages>7</tpages><orcidid>https://orcid.org/0009-0005-5203-2279</orcidid></addata></record> |
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| subjects | Aged Antiemetics - administration & dosage Antiemetics - therapeutic use Arthroplasty, Replacement, Knee - adverse effects dexamethasone Dexamethasone - administration & dosage Dexamethasone - adverse effects Double-Blind Method Female Humans Male Metoclopramide - administration & dosage Middle Aged Morphine - administration & dosage Morphine - adverse effects perioperative period postoperative nausea and vomiting (PONV) Postoperative Nausea and Vomiting - epidemiology Postoperative Nausea and Vomiting - etiology Postoperative Nausea and Vomiting - prevention & control randomized controlled trial total knee arthroplasty (TKA) |
| title | Perioperative Dexamethasone Split Between Two Doses Further Reduced Early Postoperative Nausea and Vomiting Than Single-Dose Dexamethasone: A Randomized Blinded Placebo-Controlled Trial |
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