The Effect of Dexamethasone on Pain After Total Knee Replacement Surgery
The Effect of Dexamethasone on Pain After Total 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.
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.
Inclusion Criteria:

 -  primary total knee replacement surgery

 -  ASA (american society of anesthesiologists) class 1-3

 Exclusion Criteria:

 -  severe coronary artery disease, heart failure, kidney failure

 -  insulin-dependent DM (diabetes mellitus), poorly controlled type II DM

 -  gastric/duodenal ulcer

 -  allergy/contra-indication for any drug used in the study

 -  corticosteroid use during last 3 months

 -  preoperative use of opioid drugs (excl. codeine, tramadol)

 -  neuropathy/sensory impairment of lower limbs

 -  lack of co-operation, e.g. inability to use a PCA (patient controlled
 analgesia)-device