Dexamethasone Attenuates the Perioperative Acute Phase Response for Simultaneous Bilateral Total Hip Arthroplasty.

Abstract

This study aimed to evaluate the effect of perioperative dexamethasone on acute phase response (APR) after simultaneous bilateral total hip arthroplasty (SimBTHA). A retrospective case-control study was performed on 177 SimBTHA procedures. The patients were divided into 2 cohorts: patients receiving perioperative dexamethasone and patients in whom no dexamethasone was administered. We observed the effects of perioperative dexamethasone on the APR following SimBTHA by trending C-reactive protein and interleukin-6. Besides, the incidence of postoperative nausea and vomiting (PONV), postoperative visual analog scale (VAS) score, use of antiemetic and analgesic rescue, and complications were also compared. Compared to the no dexamethasone group, patients receiving dexamethasone yielded a significantly decreased C-reactive protein on postoperative days 1, 2 and 3. Such differences of interleukin-6 were also detected. In addition, the incidence of PONV, postoperative VAS score, and use of antiemetic and analgesic rescue were significantly decreased without increasing the risk of early surgical wound infection and gastrointestinal hemorrhage in patients receiving dexamethasone. The anti-inflammatory effects of dexamethasone can attenuate the APR after SimBTHA as well as decrease the PONV, postoperative VAS score, and use of antiemetic and analgesic rescue.