The efficacy of dexamethasone on pain management for knee arthroscopy

Peng, Chuangang; Li, Chen; Yuan, Baoming; Jiao, Jianhang

doi:10.1097/md.0000000000019417

Cited by 6 publications

(4 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…31 Dexamethasone has been found to have stronger analgesic benefit in both spine and ear, nose, and throat surgeries. 30 Comparably stronger analgesic benefit has also been identified in a meta-analyses of dexamethasone and other corticosteroids in patients undergoing joint arthroplasty, 32 knee arthroscopy, 33 and tonsillectomy. 34 It seems, therefore, that dexamethasone has useful analgesic properties in some types of surgery, and may also be helpful for patients at risk of opioid-related side effects.…”

Section: Postoperative Painmentioning

confidence: 95%

Benefits and Risks of Dexamethasone in Noncardiac Surgery

Myles

Corcoran

2021

Anesthesiology

View full text Add to dashboard Cite

show abstract

Section: Postoperative Painmentioning

confidence: 95%

Benefits and Risks of Dexamethasone in Noncardiac Surgery

Myles

Corcoran

2021

Anesthesiology

View full text Add to dashboard Cite

show abstract

“…The only difference between groups was observed two weeks after surgery when the betamethasone group had better KOOS score than the celecoxib and control groups. Corticosteroids have been studied as an adjunctive therapy administered during surgery to alleviate pain and reduce analgesics consumption in the early postoperative period following arthroscopic knee procedures [15, 16]. Postoperative pain reduction after intraarticular corticosteroid injection during surgery can be attributed to its anti‐inflammatory properties [11].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, no standard protocols have been established for pain management after APM. However, common approaches include local intra‐articular steroid injections, over the counter analgesics, nonsteroidal anti‐inflammatories and opioids [4, 15–17]. Preoperative experimental pain sensitivity predicts acute postoperative pain [10] and can be assessed by different types of stimuli.…”

Section: Introductionmentioning

confidence: 99%

Preoperative pain sensitivity questionnaire helps customize pain management after arthroscopic partial meniscectomy

Yaari

Dolev

Kittani

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose To evaluate correlations between preoperative pain sensitivity and postoperative analgesic consumption together with pain perception shortly after arthroscopic partial meniscectomy in non-arthritic knees. Methods Ninety-nine patients who underwent primary arthroscopic meniscectomy were prospectively divided into three postoperative treatment groups that were prescribed with betamethasone injection (at the end of surgery), oral celecoxib or rescue analgesia (control). Preoperative pain sensitivity was evaluated by pain sensitivity questionnaires (PSQ). Patients were followed for the irst three postoperative weeks to evaluate knee injury and osteoarthritis outcome score (KOOS) pain scores and analgesics consumption. Statistical analysis included correlations among preoperative pain sensitivity, postoperative pain levels and analgesics consumption. A receiver operating characteristic curve was plotted to investigate the cutof values of the PSQ score to predict insuicient postoperative pain reduction. Results There were no diferences at baseline among all study groups in age, sex, BMI, level of activity, comorbidities and surgical indings. At the inal follow-up, KOOS pain scores improved in all groups (p < 0.001). Mean inal KOOS pain scores were 76.1 ± 15.2 for the betamethasone group, 70.8 ± 12.6 for the celecoxib group and 78.7 ± 11.6 for the control group. No diferences in scores were observed among groups (n.s.). In the control group, a negative correlation was observed between PSQ score and KOOS-pain scores at the end of the follow-up in addition to a positive correlation between PSQ score and rescue analgesia consumption at the irst postoperative week. The optimal cutof value for PSQ score to predict insuicient improvement in KOOS-pain subscale was 5.0 points. Conclusions A cutof value of pain sensitivity questionnaire score above 5.0 points was determined to identify patients with higher sensitivity to pain who underwent arthroscopic partial meniscectomy. These patients reported relatively increased pain and consumed more rescue analgesics postoperatively unless treated with a single intraoperative corticosteroids injection or oral non-steroidal anti-inlammatories. Therefore, surgeons can use pain sensitivity questionnaire score as a preoperative tool to identify patients with high sensitivity to pain and customize their postoperative analgesics protocol to better it their pain levels. Level of evidence II.

show abstract

“…Recent data support a recommendation to preferentially administer dexamethasone 8 mg in adult patients to maximise potential benefit [ 99 ]. Higher intra‐operative dosing is, therefore, now increasingly acceptable and further supported by evidence that dexamethasone is an effective analgesic adjunct [ 107 , 108 , 109 , 110 ] that can further facilitate enhanced recovery [ 110 , 111 , 112 , 113 ].…”

Section: Safetymentioning

confidence: 99%

Postoperative systemic inflammatory dysregulation and corticosteroids: a narrative review

et al. 2022

View full text Add to dashboard Cite

In some patients, the inflammatory-immune response to surgical injury progresses to a harmful, dysregulated state. We posit that postoperative systemic inflammatory dysregulation forms part of a pathophysiological response to surgical injury that places patients at increased risk of complications and subsequently prolongs hospital stay. In this narrative review, we have outlined the evolution, measurement and prediction of postoperative systemic inflammatory dysregulation, distinguishing it from a healthy and self-limiting host response. We reviewed the actions of glucocorticoids and the potential for heterogeneous responses to perioperative corticosteroid supplementation. We have then appraised the evidence highlighting the safety of corticosteroid supplementation, and the potential benefits of high/repeated doses to reduce the risks of major complications and death. Finally, we addressed how clinical trials in the future should target patients at higher risk of peri-operative inflammatory complications, whereby corticosteroid regimes should be tailored to modify not only the a priori risk, but also further adjusted in response to markers of an evolving pathophysiological response.

show abstract

The efficacy of dexamethasone on pain management for knee arthroscopy

Cited by 6 publications

References 34 publications

Benefits and Risks of Dexamethasone in Noncardiac Surgery

Benefits and Risks of Dexamethasone in Noncardiac Surgery

Preoperative pain sensitivity questionnaire helps customize pain management after arthroscopic partial meniscectomy

Postoperative systemic inflammatory dysregulation and corticosteroids: a narrative review

Contact Info

Product

Resources

About