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Perioperative Systemic Corticosteroids in Modern Total Hip and Knee Arthroplasty: A Primer for Clinical Practice.
Palmer, Ryan C; Jones, Ian A; Sculco, Peter K; Hannon, Charles P; Fillingham, Yale A; Heckmann, Nathanael D.
Afiliación
  • 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.
JBJS Rev ; 12(9)2024 Sep 01.
Article en En | MEDLINE | ID: mdl-39283972
ABSTRACT
¼ Perioperative corticosteroids are strongly recommended for reducing the incidence and severity of postoperative nausea and vomiting following elective total hip or total knee arthroplasty.¼ 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).¼ 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.¼ 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.¼ 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corticoesteroides / Atención Perioperativa / Artroplastia de Reemplazo de Cadera / Artroplastia de Reemplazo de Rodilla Límite: Humans Idioma: En Revista: JBJS Rev Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corticoesteroides / Atención Perioperativa / Artroplastia de Reemplazo de Cadera / Artroplastia de Reemplazo de Rodilla Límite: Humans Idioma: En Revista: JBJS Rev Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos