Methylprednisolone improves pain control, sleep quality after hip replacement: Study
Iran: Preoperative administration of 125 mg of methylprednisolone in patients undergoing total hip arthroplasty improves pain control and sleep quality after the surgery, finds a recent study published in Arthroplast Today.
Seyyed Hossein Shafiei, Tehran University of Medical Sciences, Tehran, Iran, and colleagues performed a double-blind, randomized controlled trial to evaluate the efficacy of preoperative high-dose methylprednisolone on pain levels and sleep quality following primary total hip arthroplasty.
The trial was performed in adults undergoing total hip arthroplasty. The researchers utilized a computer-generated, permuted-block randomization scheme with a 1:1 ratio between the intervention (125 mg methylprednisolone) and control groups (normal saline). A similar preoperative and postoperative protocol was followed for both the patient groups.
A visual analog scale (VAS) was used for pain assessment. Assessment of the sleep quality was done at the 2-week postoperative visit using the Pittsburgh Sleep Quality Index (PSQI).
The researchers reported the following findings:
- With a total of 70 patients, 35 patients were included in the intervention and placebo groups.
- Hospital stay was significantly shorter in the intervention group (1.5 ± 0.7 vs 2.0 ± 0.5 days).
- Preoperative pain levels were similar between groups, while satisfactory pain control was achieved in a significantly larger number of patients in the intervention group (18 vs 8 patients).
- The intervention group was significantly more likely to have a good sleep quality than the placebo groups (74% vs 31%).
- No significant differences were found between preoperative and postoperative blood sugar levels.
- No cases of early postoperative wound complication, infection, or deep vein thrombosis among our patients were observed.
The researchers wrote in their conclusion, "preoperative administration of 125 mg of methylprednisolone in the randomized controlled trial was found to improve sleep quality, as measured by PSQI, 2 weeks following surgery, and pain control, as measured by VAS, 24 hours after surgery."
Reference:
Shafiei SH, Siavashi B, Ghasemi M, Golbakhsh MR, Baghdadi S. Single High-Dose Systemic Methylprednisolone Administered Preoperatively Improves Pain Control and Sleep Quality After Total Hip Arthroplasty: A Double-Blind, Randomized Controlled Trial. Arthroplast Today. 2022 May 30;16:78-82. doi: 10.1016/j.artd.2022.03.006. PMID: 35662994; PMCID: PMC9160665.
