<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03034733</url>
  </required_header>
  <id_info>
    <org_study_id>Polvitepdexa 24052016</org_study_id>
    <nct_id>NCT03034733</nct_id>
  </id_info>
  <brief_title>The Effect of Dexamethasone on Pain After Total Knee Replacement Surgery</brief_title>
  <official_title>The Effect of Intravenous Single-dose Dexamethasone on Pain After Total Knee Replacement Surgery</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of Oulu</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>University of Oulu</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The purpose of this study is to examine, if a single-dose of dexamethasone given during the&#xD;
      operation, alleviates pain after knee replacement surgery.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      The purpose of this study is to examine, if a single-dose of dexamethasone given during the&#xD;
      operation, alleviates pain after knee replacement surgery. This is also a dose-finding study&#xD;
      comparing two doses of dexamethasone.&#xD;
&#xD;
      Total knee arthroplasty causes considerable pain. Multimodal analgesia and peripheral nerve&#xD;
      blocks are used for treatment of pain. Some studies suggest that glucocorticoids alleviate&#xD;
      postoperative pain. The optimal dose of dexamethasone in treatment of postoperative pain is&#xD;
      not known. Studies on this subject in patients with total knee replacement are sparse.&#xD;
      Potential side-effects of dexamethasone (hyperglycemia, wound infection) need to be studied.&#xD;
&#xD;
      Patients coming for primary knee replacement surgery are enrolled. The patients in each study&#xD;
      group receive multimodal therapy for postoperative pain: etoricoxib, paracetamol, gabapentin&#xD;
      and oxycodone. A single dose of intravenous dexamethasone (0,15 mg/kg or 0,25 mg/kg) or a&#xD;
      placebo (saline) is administered to the patient during the operation. The effect of&#xD;
      dexamethasone on postoperative pain is observed: main outcome is dynamic pain at 24 h&#xD;
      postoperatively. The extent of inflammatory reaction is measured (CRP). Serial blood glucose&#xD;
      measurements are done.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Terminated</overall_status>
  <why_stopped>
    Principal investigator (M.K.) left for another workplace. Patient recruitment more difficult&#xD;
    than expected.&#xD;
  </why_stopped>
  <start_date type="Actual">February 15, 2017</start_date>
  <completion_date type="Actual">January 31, 2018</completion_date>
  <primary_completion_date type="Actual">January 31, 2018</primary_completion_date>
  <phase>Phase 4</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>pain during walking, NRS 0-10</measure>
    <time_frame>at 24 hours postoperatively</time_frame>
    <description>NRS (numerical rating scale: 0=no pain, 10 = worst possible pain)</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>pain at rest, NRS 0-10</measure>
    <time_frame>preoperatively, postoperatively: at 2 hours, at 8 hours,at 24 hours, at 32 hours, at 48 hours, seventh postoperative day</time_frame>
    <description>NRS (numerical rating scale: 0=no pain, 10 = worst possible pain)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>consumption of intravenous oxycodone, milligrams/kilogram body weight</measure>
    <time_frame>postoperatively: at 2 hours, at 8 hours, at 24 hours, at 48 hours</time_frame>
    <description>cumulative dose of oxycodone administered with a PCA (patient-controlled analgesia)-device</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>nausea, NRS 0-10</measure>
    <time_frame>postoperatively: at 2 hours, at 8 hours,at 24 hours, at 32 hours, at 48 hours</time_frame>
    <description>NRS (numerical rating scale: 0=no nausea, 10 = worst possible nausea)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>general wellbeing, NRS 0-10</measure>
    <time_frame>postoperatively: at 2 hours, at 8 hours,at 24 hours, at 32 hours, at 48 hours</time_frame>
    <description>NRS (numerical rating scale: 0=worst, 10 = best)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>quality of sleep, NRS 0-10</measure>
    <time_frame>postoperatively at 24 hours, at 48 hours</time_frame>
    <description>NRS (numerical rating scale: 0=worst, 10 = best)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>time to achieve discharge criteria, hours</measure>
    <time_frame>postoperatively: at 24 hours, at 48 hours, at 72 hours, at 96 hours</time_frame>
    <description>time to achieve discharge criteria, hours</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>pain during walking, NRS 0-10</measure>
    <time_frame>preoperatively, postoperatively: at 8 hours, at 48 hours, seventh postoperative day</time_frame>
    <description>NRS (numerical rating scale: 0=no pain, 10 = worst possible pain)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>vomiting, yes/no</measure>
    <time_frame>postoperatively: at 2 hours, at 8 hours,at 24 hours, at 32 hours, at 48 hours</time_frame>
    <description>vomiting, yes/no</description>
  </secondary_outcome>
  <other_outcome>
    <measure>blood glucose, mmol/l</measure>
    <time_frame>at preoperative visit, at induction of anesthesia, postoperatively: at 2 hours, at 8 hours, at 24 hours, at 32 hours, at 48 hours</time_frame>
    <description>blood sample</description>
  </other_outcome>
  <other_outcome>
    <measure>inflammatory reaction, c-reactive protein (CRP)</measure>
    <time_frame>preoperative, postoperatively: at 24 hours, 48 hours</time_frame>
    <description>blood sample</description>
  </other_outcome>
  <other_outcome>
    <measure>wound complication, yes/no</measure>
    <time_frame>postoperatively up to 90 days</time_frame>
    <description>wound complication, yes/no</description>
  </other_outcome>
  <other_outcome>
    <measure>wound infection, yes/no</measure>
    <time_frame>postoperatively up to 90 days</time_frame>
    <description>wound infection, yes/no</description>
  </other_outcome>
  <number_of_arms>3</number_of_arms>
  <enrollment type="Actual">27</enrollment>
  <condition>Arthroplasty, Knee Replacement</condition>
  <condition>Pain, Postoperative</condition>
  <arm_group>
    <arm_group_label>dexamethasone 0,15 mg/kg</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>single-dose intravenous dexamethasone 0,15 mg/kg, intraoperative</description>
  </arm_group>
  <arm_group>
    <arm_group_label>dexamethasone 0,25 mg/kg</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>single-dose intravenous dexamethasone 0,25 mg/kg, intraoperative</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Sodium Chloride, (24)NaCl 0,9%</arm_group_label>
    <arm_group_type>Placebo Comparator</arm_group_type>
    <description>single-dose intravenous saline, intraoperative</description>
  </arm_group>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Dexamethasone</intervention_name>
    <description>intravenous dexamethasone, two groups: 0,15 mg/kg, 0,25 mg/kg</description>
    <arm_group_label>dexamethasone 0,15 mg/kg</arm_group_label>
    <arm_group_label>dexamethasone 0,25 mg/kg</arm_group_label>
    <other_name>Oradexon</other_name>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Sodium Chloride, (24)NaCl 0,9%</intervention_name>
    <description>intravenous placebo</description>
    <arm_group_label>Sodium Chloride, (24)NaCl 0,9%</arm_group_label>
    <other_name>saline</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  primary total knee replacement surgery&#xD;
&#xD;
          -  ASA (american society of anesthesiologists) class 1-3&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  severe coronary artery disease, heart failure, kidney failure&#xD;
&#xD;
          -  insulin-dependent DM (diabetes mellitus), poorly controlled type II DM&#xD;
&#xD;
          -  gastric/duodenal ulcer&#xD;
&#xD;
          -  allergy/contra-indication for any drug used in the study&#xD;
&#xD;
          -  corticosteroid use during last 3 months&#xD;
&#xD;
          -  preoperative use of opioid drugs (excl. codeine, tramadol)&#xD;
&#xD;
          -  neuropathy/sensory impairment of lower limbs&#xD;
&#xD;
          -  lack of co-operation, e.g. inability to use a PCA (patient controlled&#xD;
             analgesia)-device&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>90 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Matti Kyllönen, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Oulu University Hospital</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Oulu University Hospital</name>
      <address>
        <city>Oulu</city>
        <state>OYS</state>
        <zip>90029</zip>
        <country>Finland</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Finland</country>
  </location_countries>
  <reference>
    <citation>Lunn TH, Kehlet H. Perioperative glucocorticoids in hip and knee surgery - benefit vs. harm? A review of randomized clinical trials. Acta Anaesthesiol Scand. 2013 Aug;57(7):823-34. doi: 10.1111/aas.12115. Epub 2013 Apr 15.</citation>
    <PMID>23581549</PMID>
  </reference>
  <reference>
    <citation>Backes JR, Bentley JC, Politi JR, Chambers BT. Dexamethasone reduces length of hospitalization and improves postoperative pain and nausea after total joint arthroplasty: a prospective, randomized controlled trial. J Arthroplasty. 2013 Sep;28(8 Suppl):11-7. doi: 10.1016/j.arth.2013.05.041. Epub 2013 Aug 9.</citation>
    <PMID>23937923</PMID>
  </reference>
  <reference>
    <citation>De Oliveira GS Jr, Almeida MD, Benzon HT, McCarthy RJ. Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2011 Sep;115(3):575-88. doi: 10.1097/ALN.0b013e31822a24c2.</citation>
    <PMID>21799397</PMID>
  </reference>
  <reference>
    <citation>Gilron I. Corticosteroids in postoperative pain management: future research directions for a multifaceted therapy. Acta Anaesthesiol Scand. 2004 Nov;48(10):1221-2. doi: 10.1111/j.1399-6576.2004.00581.x. No abstract available.</citation>
    <PMID>15504179</PMID>
  </reference>
  <reference>
    <citation>Holte K, Kehlet H. Perioperative single-dose glucocorticoid administration: pathophysiologic effects and clinical implications. J Am Coll Surg. 2002 Nov;195(5):694-712. doi: 10.1016/s1072-7515(02)01491-6. No abstract available.</citation>
    <PMID>12437261</PMID>
  </reference>
  <reference>
    <citation>Husted H, Lunn TH, Troelsen A, Gaarn-Larsen L, Kristensen BB, Kehlet H. Why still in hospital after fast-track hip and knee arthroplasty? Acta Orthop. 2011 Dec;82(6):679-84. doi: 10.3109/17453674.2011.636682. Epub 2011 Nov 9.</citation>
    <PMID>22066560</PMID>
  </reference>
  <reference>
    <citation>Kehlet H. Glucocorticoids for peri-operative analgesia: how far are we from general recommendations? Acta Anaesthesiol Scand. 2007 Oct;51(9):1133-5. doi: 10.1111/j.1399-6576.2007.01459.x. No abstract available.</citation>
    <PMID>17850557</PMID>
  </reference>
  <reference>
    <citation>Koh IJ, Chang CB, Lee JH, Jeon YT, Kim TK. Preemptive low-dose dexamethasone reduces postoperative emesis and pain after TKA: a randomized controlled study. Clin Orthop Relat Res. 2013 Sep;471(9):3010-20. doi: 10.1007/s11999-013-3032-5. Epub 2013 May 4.</citation>
    <PMID>23645340</PMID>
  </reference>
  <reference>
    <citation>Lunn TH, Kristensen BB, Andersen LO, Husted H, Otte KS, Gaarn-Larsen L, Kehlet H. Effect of high-dose preoperative methylprednisolone on pain and recovery after total knee arthroplasty: a randomized, placebo-controlled trial. Br J Anaesth. 2011 Feb;106(2):230-8. doi: 10.1093/bja/aeq333. Epub 2010 Dec 3.</citation>
    <PMID>21131371</PMID>
  </reference>
  <reference>
    <citation>Richards JE, Kauffmann RM, Zuckerman SL, Obremskey WT, May AK. Relationship of hyperglycemia and surgical-site infection in orthopaedic surgery. J Bone Joint Surg Am. 2012 Jul 3;94(13):1181-6. doi: 10.2106/JBJS.K.00193.</citation>
    <PMID>22760385</PMID>
  </reference>
  <reference>
    <citation>Romundstad L, Breivik H, Niemi G, Helle A, Stubhaug A. Methylprednisolone intravenously 1 day after surgery has sustained analgesic and opioid-sparing effects. Acta Anaesthesiol Scand. 2004 Nov;48(10):1223-31. doi: 10.1111/j.1399-6576.2004.00480.x.</citation>
    <PMID>15504180</PMID>
  </reference>
  <reference>
    <citation>Salerno A, Hermann R. Efficacy and safety of steroid use for postoperative pain relief. Update and review of the medical literature. J Bone Joint Surg Am. 2006 Jun;88(6):1361-72. doi: 10.2106/JBJS.D.03018.</citation>
    <PMID>16757774</PMID>
  </reference>
  <reference>
    <citation>Sauerland S, Nagelschmidt M, Mallmann P, Neugebauer EA. Risks and benefits of preoperative high dose methylprednisolone in surgical patients: a systematic review. Drug Saf. 2000 Nov;23(5):449-61. doi: 10.2165/00002018-200023050-00007.</citation>
    <PMID>11085349</PMID>
  </reference>
  <reference>
    <citation>Waldron NH, Jones CA, Gan TJ, Allen TK, Habib AS. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis. Br J Anaesth. 2013 Feb;110(2):191-200. doi: 10.1093/bja/aes431. Epub 2012 Dec 5.</citation>
    <PMID>23220857</PMID>
  </reference>
  <reference>
    <citation>Smith C, Erasmus PJ, Myburgh KH. Endocrine and immune effects of dexamethasone in unilateral total knee replacement. J Int Med Res. 2006 Nov-Dec;34(6):603-11. doi: 10.1177/147323000603400605.</citation>
    <PMID>17294992</PMID>
  </reference>
  <reference>
    <citation>Kardash KJ, Sarrazin F, Tessler MJ, Velly AM. Single-dose dexamethasone reduces dynamic pain after total hip arthroplasty. Anesth Analg. 2008 Apr;106(4):1253-7, table of contents. doi: 10.1213/ANE.0b013e318164f319.</citation>
    <PMID>18349202</PMID>
  </reference>
  <verification_date>November 2018</verification_date>
  <study_first_submitted>January 3, 2017</study_first_submitted>
  <study_first_submitted_qc>January 24, 2017</study_first_submitted_qc>
  <study_first_posted type="Estimate">January 27, 2017</study_first_posted>
  <last_update_submitted>November 27, 2018</last_update_submitted>
  <last_update_submitted_qc>November 27, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">November 29, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Arthroplasty</keyword>
  <keyword>Knee Replacement</keyword>
  <keyword>Pain, Postoperative</keyword>
  <keyword>Glucocorticoids</keyword>
  <keyword>Dexamethasone</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Pain, Postoperative</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Dexamethasone</mesh_term>
  </intervention_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03034733
org study id: Polvitepdexa 24052016
nct id: NCT03034733
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The purpose of this study is to examine, if a single-dose of dexamethasone given during the
      operation, alleviates pain after knee replacement surgery.
The purpose of this study is to examine, if a single-dose of dexamethasone given during the
      operation, alleviates pain after knee replacement surgery. This is also a dose-finding study
      comparing two doses of dexamethasone.

      Total knee arthroplasty causes considerable pain. Multimodal analgesia and peripheral nerve
      blocks are used for treatment of pain. Some studies suggest that glucocorticoids alleviate
      postoperative pain. The optimal dose of dexamethasone in treatment of postoperative pain is
      not known. Studies on this subject in patients with total knee replacement are sparse.
      Potential side-effects of dexamethasone (hyperglycemia, wound infection) need to be studied.

      Patients coming for primary knee replacement surgery are enrolled. The patients in each study
      group receive multimodal therapy for postoperative pain: etoricoxib, paracetamol, gabapentin
      and oxycodone. A single dose of intravenous dexamethasone (0,15 mg/kg or 0,25 mg/kg) or a
      placebo (saline) is administered to the patient during the operation. The effect of
      dexamethasone on postoperative pain is observed: main outcome is dynamic pain at 24 h
      postoperatively. The extent of inflammatory reaction is measured (CRP). Serial blood glucose
      measurements are done.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
measure: pain during walking, NRS 0-10
time frame: at 24 hours postoperatively
description: NRS (numerical rating scale: 0=no pain, 10 = worst possible pain)
measure: pain at rest, NRS 0-10
time frame: preoperatively, postoperatively: at 2 hours, at 8 hours,at 24 hours, at 32 hours, at 48 hours, seventh postoperative day
description: NRS (numerical rating scale: 0=no pain, 10 = worst possible pain)
measure: consumption of intravenous oxycodone, milligrams/kilogram body weight
time frame: postoperatively: at 2 hours, at 8 hours, at 24 hours, at 48 hours
description: cumulative dose of oxycodone administered with a PCA (patient-controlled analgesia)-device
measure: nausea, NRS 0-10
time frame: postoperatively: at 2 hours, at 8 hours,at 24 hours, at 32 hours, at 48 hours
description: NRS (numerical rating scale: 0=no nausea, 10 = worst possible nausea)
measure: general wellbeing, NRS 0-10
time frame: postoperatively: at 2 hours, at 8 hours,at 24 hours, at 32 hours, at 48 hours
description: NRS (numerical rating scale: 0=worst, 10 = best)
measure: quality of sleep, NRS 0-10
time frame: postoperatively at 24 hours, at 48 hours
description: NRS (numerical rating scale: 0=worst, 10 = best)
measure: time to achieve discharge criteria, hours
time frame: postoperatively: at 24 hours, at 48 hours, at 72 hours, at 96 hours
description: time to achieve discharge criteria, hours
measure: pain during walking, NRS 0-10
time frame: preoperatively, postoperatively: at 8 hours, at 48 hours, seventh postoperative day
description: NRS (numerical rating scale: 0=no pain, 10 = worst possible pain)
measure: vomiting, yes/no
time frame: postoperatively: at 2 hours, at 8 hours,at 24 hours, at 32 hours, at 48 hours
description: vomiting, yes/no
measure: blood glucose, mmol/l
time frame: at preoperative visit, at induction of anesthesia, postoperatively: at 2 hours, at 8 hours, at 24 hours, at 32 hours, at 48 hours
description: blood sample
measure: inflammatory reaction, c-reactive protein (CRP)
time frame: preoperative, postoperatively: at 24 hours, 48 hours
description: blood sample
measure: wound complication, yes/no
time frame: postoperatively up to 90 days
description: wound complication, yes/no
measure: wound infection, yes/no
time frame: postoperatively up to 90 days
description: wound infection, yes/no
arm group label: dexamethasone 0,15 mg/kg
arm group type: Experimental
description: single-dose intravenous dexamethasone 0,15 mg/kg, intraoperative
arm group label: dexamethasone 0,25 mg/kg
arm group type: Experimental
description: single-dose intravenous dexamethasone 0,25 mg/kg, intraoperative
arm group label: Sodium Chloride, (24)NaCl 0,9%
arm group type: Placebo Comparator
description: single-dose intravenous saline, intraoperative
intervention type: Drug
intervention name: Dexamethasone
description: intravenous dexamethasone, two groups: 0,15 mg/kg, 0,25 mg/kg
arm group label: dexamethasone 0,15 mg/kg
arm group label: dexamethasone 0,25 mg/kg
other name: Oradexon
intervention type: Drug
intervention name: Sodium Chloride, (24)NaCl 0,9%
description: intravenous placebo
arm group label: Sodium Chloride, (24)NaCl 0,9%
other name: saline
criteria: 
gender: All
minimum age: 18 Years
maximum age: 90 Years
healthy volunteers: No
last name: Matti Kyllönen, MD
role: Principal Investigator
affiliation: Oulu University Hospital
facility: 
country: Finland
citation: Lunn TH, Kehlet H. Perioperative glucocorticoids in hip and knee surgery - benefit vs. harm? A review of randomized clinical trials. Acta Anaesthesiol Scand. 2013 Aug;57(7):823-34. doi: 10.1111/aas.12115. Epub 2013 Apr 15.
PMID: 23581549
citation: Backes JR, Bentley JC, Politi JR, Chambers BT. Dexamethasone reduces length of hospitalization and improves postoperative pain and nausea after total joint arthroplasty: a prospective, randomized controlled trial. J Arthroplasty. 2013 Sep;28(8 Suppl):11-7. doi: 10.1016/j.arth.2013.05.041. Epub 2013 Aug 9.
PMID: 23937923
citation: De Oliveira GS Jr, Almeida MD, Benzon HT, McCarthy RJ. Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2011 Sep;115(3):575-88. doi: 10.1097/ALN.0b013e31822a24c2.
PMID: 21799397
citation: Gilron I. Corticosteroids in postoperative pain management: future research directions for a multifaceted therapy. Acta Anaesthesiol Scand. 2004 Nov;48(10):1221-2. doi: 10.1111/j.1399-6576.2004.00581.x. No abstract available.
PMID: 15504179
citation: Holte K, Kehlet H. Perioperative single-dose glucocorticoid administration: pathophysiologic effects and clinical implications. J Am Coll Surg. 2002 Nov;195(5):694-712. doi: 10.1016/s1072-7515(02)01491-6. No abstract available.
PMID: 12437261
citation: Husted H, Lunn TH, Troelsen A, Gaarn-Larsen L, Kristensen BB, Kehlet H. Why still in hospital after fast-track hip and knee arthroplasty? Acta Orthop. 2011 Dec;82(6):679-84. doi: 10.3109/17453674.2011.636682. Epub 2011 Nov 9.
PMID: 22066560
citation: Kehlet H. Glucocorticoids for peri-operative analgesia: how far are we from general recommendations? Acta Anaesthesiol Scand. 2007 Oct;51(9):1133-5. doi: 10.1111/j.1399-6576.2007.01459.x. No abstract available.
PMID: 17850557
citation: Koh IJ, Chang CB, Lee JH, Jeon YT, Kim TK. Preemptive low-dose dexamethasone reduces postoperative emesis and pain after TKA: a randomized controlled study. Clin Orthop Relat Res. 2013 Sep;471(9):3010-20. doi: 10.1007/s11999-013-3032-5. Epub 2013 May 4.
PMID: 23645340
citation: Lunn TH, Kristensen BB, Andersen LO, Husted H, Otte KS, Gaarn-Larsen L, Kehlet H. Effect of high-dose preoperative methylprednisolone on pain and recovery after total knee arthroplasty: a randomized, placebo-controlled trial. Br J Anaesth. 2011 Feb;106(2):230-8. doi: 10.1093/bja/aeq333. Epub 2010 Dec 3.
PMID: 21131371
citation: Richards JE, Kauffmann RM, Zuckerman SL, Obremskey WT, May AK. Relationship of hyperglycemia and surgical-site infection in orthopaedic surgery. J Bone Joint Surg Am. 2012 Jul 3;94(13):1181-6. doi: 10.2106/JBJS.K.00193.
PMID: 22760385
citation: Romundstad L, Breivik H, Niemi G, Helle A, Stubhaug A. Methylprednisolone intravenously 1 day after surgery has sustained analgesic and opioid-sparing effects. Acta Anaesthesiol Scand. 2004 Nov;48(10):1223-31. doi: 10.1111/j.1399-6576.2004.00480.x.
PMID: 15504180
citation: Salerno A, Hermann R. Efficacy and safety of steroid use for postoperative pain relief. Update and review of the medical literature. J Bone Joint Surg Am. 2006 Jun;88(6):1361-72. doi: 10.2106/JBJS.D.03018.
PMID: 16757774
citation: Sauerland S, Nagelschmidt M, Mallmann P, Neugebauer EA. Risks and benefits of preoperative high dose methylprednisolone in surgical patients: a systematic review. Drug Saf. 2000 Nov;23(5):449-61. doi: 10.2165/00002018-200023050-00007.
PMID: 11085349
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responsible party type: Sponsor
mesh term: Pain, Postoperative
mesh term: Dexamethasone
sharing ipd: No