Perioperative Systemic Corticosteroids in Modern Total Hip and Knee Arthroplasty: A Primer for Clinical Practice.

Autor:	Palmer RC; Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California., Jones IA; Department of Anaesthesiology & Pain Medicine, University of Washington, Seattle, Washington., Sculco PK; Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York., Hannon CP; Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota., Fillingham YA; The Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania., Heckmann ND; Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Jazyk:	angličtina
Zdroj:	JBJS reviews [JBJS Rev] 2024 Sep 16; Vol. 12 (9). Date of Electronic Publication: 2024 Sep 16 (Print Publication: 2024).
DOI:	e24.00107
Abstrakt:	» Perioperative corticosteroids are strongly recommended for reducing the incidence and severity of postoperative nausea and vomiting following elective total hip or total knee arthroplasty.» Corticosteroids may reduce postoperative pain and opioid requirements. Similarly, corticosteroids appear to have a neutral-to-positive effect on length of stay, venous thromboembolism, mobility, delirium, acute kidney injury, and bone cement implantation syndrome (i.e., decreased length of stay).» Perioperative corticosteroids may induce hyperglycemia among both diabetic and nondiabetic patients; however, there is no strong evidence indicating that these transient corticosteroid-induced glycemic derangements may increase the risk of postoperative infectious complications.» The dosage and frequency of perioperative corticosteroid administration play a critical role in optimizing postoperative outcomes, with higher doses showing promise in reducing opioid consumption, postoperative pain, and length of stay.» The optimal dosage and frequency of corticosteroids remain unclear; however, the perioperative administration of 8 to 16 mg dexamethasone, or equivalent steroid, appears reasonable and safe in most cases. Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/B151). (Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated.)
Databáze:	MEDLINE
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