This study aims to determine if oral dexamethasone provides clinically significant improvement in postoperative outcomes, specifically nausea and pain scores.
Protocols in perioperative pain management during total joint arthroplasty (TJA) have contributed to early discharge after surgery. As practices move to favor ambulatory surgery in total joint arthroplasty changes must be made to postoperative pain and nausea management. Spinal anesthesia has been essential in managing associated ambulatory TJA, however, nausea and vomiting are known detrimental side effects. The use of systemic steroids has also been shown in the literature to reduce pain scores, length of stay, the need for antiemetics, and increase the distance of ambulation without increasing the rate of surgical site infection or prosthetic joint infection. As more same-day total joint replacement is incorporated into practice, an oral alternative may prove beneficial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
300
4 mg bid for 4 days
oral placebo
Postoperative Pain
Postoperative pain will be collected via visual analog scores
Time frame: 3 weeks following surgery
Postoperative Nausea
Postoperative Nausea will be collected via visual analog scores
Time frame: 3 weeks following surgery
Opioid Consumption
Opioid consumption will be recorded by participant in assigned journal, morphine equivalence will be recorded
Time frame: 6 months
Antiemetic Consumption
Time frame: 6 months
Episodes of Nausea
Time frame: 3 weeks
Postoperative complications
Incidence of surgical site infection, acute prosthetic joint infection
Time frame: 6 months
Patient-reported outcome scores (PROMS)
Time frame: 6 months
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Time frame: 6 months
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