Abstract:
BACKGROUND:High-dose glucocorticoid may reduce postsurgical pain and improve recovery. We hypothesized that 125 mg methylprednisolone (MP) would reduce time to meet functional discharge criteria after total hip arthroplasty (THA). METHODS:Forty-eight patients undergoing unilateral THA under spinal anaesthesia were consecutively included in this randomized, double-blind, placebo-controlled trial receiving preoperative i.v. MP or saline. All patients received a standardized, multimodal analgesic regime with paracetamol, celecoxib, and gabapentin. The primary outcome was time to meet well-defined functional discharge criteria. Secondary outcomes were handgrip strength and endurance, pain, nausea, vomiting, fatigue, sleep quality, and rescue analgesic-, antiemetic-, and hypnotic medicine requirements. The inflammatory response measured by C-reactive protein (CRP) and actual length of stay were also registered. Discharge criteria were assessed twice daily (at 09:00 and 14:00 h) until discharge. Other outcomes were assessed at 2, 4, 6, 8, and 24 h after operation, and also in a questionnaire from postoperative day (POD) 1-4. RESULTS:Time to meet discharge criteria was [median (IQR) (95% CI), MP vs placebo]: 23.5 (23.3-23.7) (17.8-43.8) vs 23.5 (23.0-23.8) (20.0-46.8) h, the mean difference (95% CI) being -1.3 (-4.7 to 2.2) h, P=0.65. Overall pain for the first 24 h after surgery was significantly reduced in the MP vs the placebo group (P<0.01), as was CRP at 24 h (P<0.0001). No other between-group differences were observed. No drug-related complications were observed at follow-up on POD30. CONCLUSIONS:MP 125 mg i.v. before surgery added to a multimodal oral analgesic regime did not reduce time to meet functional discharge criteria after THA, but improved analgesia for the first 24 h.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Lunn TH,Andersen LØ,Kristensen BB,Husted H,Gaarn-Larsen L,Bandholm T,Ladelund S,Kehlet Hdoi
10.1093/bja/aes345subject
Has Abstractpub_date
2013-01-01 00:00:00pages
66-73issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)32851-9journal_volume
110pub_type
杂志文章,随机对照试验abstract::We have studied the tone of the lower oesophageal sphincter (LOS) in 40 adults undergoing routine body surface surgery and allocated randomly to receive anaesthesia either by face mask and Guedel airway or by laryngeal mask airway. In the laryngeal mask group there was a mean (SEM) decrease in barrier pressure (LOS mi...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1992-10-01 00:00:00
abstract::We describe an obstetric patient who developed incapacitating headache after inadvertent dural tap and was treated with repeated blood patching. She subsequently developed severe lumbar back pain which, after exclusion of suspected extradural abscess, was treated successfully with simple analgesics and physiotherapy. ...
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journal_title:British journal of anaesthesia
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1998-04-01 00:00:00
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journal_title:British journal of anaesthesia
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更新日期:1987-03-01 00:00:00
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