A meta-analysis on effect of dexamethasone as an analgesic adjuvant to pain treatment after total knee arthroplasty
Keywords:
meta-analysis, dexamethasone, pain, total-knee arthroplasty, publication bias, forest plot, randomized controlled trial (RCT)Abstract
Background: Pain management after a total-knee arthroplasty (TKA) has become an important issue in the field of medicine. Objective: This study conducted a meta-analysis from randomized controlled trials (RCTs) to assess the efficacy and safety of dexamethasone for pain management after TKA. Methods: PubMed, Medline, Embase, ScienceDirect, and the Cochrane Library were searched up to December 2021 for comparative RCTs involving dexamethasone and placebo for pain control after TKA. Primary outcomes were postoperative pain scores and opioid consumption. Secondary outcomes were length of hospital stay, adverse effects, and postoperative complications. We assessed statistical heterogeneity for each RCT with the use of a standard Chi-squared test and the I2 statistic. Results: A total of 5 RCTs were included. The present meta-analysis indicated that there were significant differences between dexamethasone-treated groups and placebo groups regarding postoperative pain scores at 12, 24, and 48hours after TKA. Administering dexamethasone could significantly reduce opioid consumption at 12hours after TKA. However, no significant difference was found in opioid consumption at 24 and 48hours after TKA. There was a decreased risk of adverse effects in dexamethasone groups. A fixed-effects model was adopted when I2<50% and P>.05; otherwise, the random effects model was adopted.
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