Multiple Low Doses of Intravenous Corticosteroids to Improve Early Rehabilitation in Total Knee Arthroplasty: A Randomized Clinical Trial
Autor: | Fuxing Pei, Bin Shen, Donghai Li, Jinhai Zhao, Pengde Kang, Zhouyuan Yang |
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Rok vydání: | 2018 |
Předmět: |
Male
Fever Hydrocortisone Visual Analog Scale Nausea Visual analogue scale medicine.medical_treatment law.invention 03 medical and health sciences 0302 clinical medicine Patient satisfaction Double-Blind Method Randomized controlled trial law Sleep Initiation and Maintenance Disorders medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Knee Glucocorticoids Saline Pain Postoperative 030222 orthopedics Dose-Response Relationship Drug Interleukin-6 business.industry 030229 sport sciences Middle Aged Arthroplasty C-Reactive Protein Anesthesia Postoperative Nausea and Vomiting Vomiting Female Surgery medicine.symptom business medicine.drug |
Zdroj: | The Journal of Knee Surgery. 32:171-179 |
ISSN: | 1938-2480 1538-8506 |
Popis: | Low doses of corticosteroids have been proved to be effective in decreasing the inflammatory cytokines and relieving the pain. However, the optimal dosage of corticosteroids in total knee arthroplasty (TKA) is undetermined. A total of 103 patients were randomly divided into three groups. Group A containing 32 patients received normal saline. Group B including 36 patients used two doses of 100 mg hydrocortisone, given 2 hours before and 8 hours after surgery. Group C involving 35 patients received four doses of 100 mg hydrocortisone, 8 hours apart.The level of interleukin 6 (IL-6) and C-reactive protein (CRP) were lower in group C than those in group A when detected at 12, 24, and 48 hours after operation and even lower than that in group B at 24 and 48 hours (p 0.05), but it did not show statistic difference 24 hours later (p > 0.05). For comparison, patients with multiple doses achieved continuously better outcomes on pain management than the blank control group within postoperative 36 hours at rest and at 24 hours with activity. In addition, patients using multiple doses of hydrocortisone achieved fewer occurrences of nausea and vomiting, fever, and sleeplessness, better knee function recovery, better patient satisfaction, and shorter length of hospital stays (p Multiple dose of hydrocortisone was benefit to the pain management and early rehabilitation in TKA and may be recommended to the clinical practice. |
Databáze: | OpenAIRE |
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