Dexamethasone Administration reduces pain without disturbing blood sugar After TKA in Type 2 Diabetes Patients: Study

• DXM group (n = 66)

• Non-DXM group (n = 95)

All other perioperative treatments and medications were the same for both groups. The investigators assessed postoperative pain scores, the incidence of postoperative nausea and vomiting (PONV), length of hospital stay, PBG levels, and other clinical data.

Results

• There was no difference between the DXM and non-DXM groups for any preoperative characteristics. Key findings were as follows:

• PBG Levels: The average of PBG levels was comparable (10.84 mg/dL vs. 11.05 mg/dL), and the rate of patients with PBG larger than 200 mg/dL was comparative (43.2% vs. 43.9%).

• Pain Scores: Comparison of postoperative VAS scores between DXM and non-DXM groups, the latter had higher values (2.48 vs. 3.67).

• PONV Rates: The cumulative incidence of PONV was significantly less in the DXM group (16% vs. 40%).

• Prediction of PBG: Preoperative glycated hemoglobin levels have been shown to predict the actual PBG.

• Early postoperative complications were not significantly different between groups.

The study authors concluded that dexamethasone significantly reduces pain and PONV without having a clinically relevant effect on blood glucose levels in patients with type 2 diabetes undergoing TKA. Preoperative glycated hemoglobin levels are an accurate predictor of perioperative blood glucose trends. These findings highlight the potential use of DXM as a useful adjunct to ERAS protocols in diabetic patients undergoing joint replacement surgeries.

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