Repeat-dose dexamethasone to prevent pain relapse after total knee arthroplasty in high-pain-response patients: A randomised, double-blind, placebo-controlled superiority trial
Primary resultResult — go to the resultOdds ratio 0.48 95% CI 0.20–1.16Authors' conclusion
The administration of a high oral dose of dexamethasone following an initial pre-operative dose of 1 mg kg -1 intravenously in selected high-pain-response patients had no effect on postoperative pain following total knee arthroplasty.
Study context
- Population
- High-pain-response patients (Pain Catastrophising Scale >20, Visual Analogue Scale (VAS) >30 walking at 24 h) after total knee arthroplasty who received pre-operative IV dexamethasone 1 mg kg −1
- Participants
- 110 patients · 2 Danish centres
- Comparison
- Oral dexamethasone 24 mg vs placebo on POD 1
- Primary endpoint
- Proportion with moderate-to-severe pain during walking
- Follow-up
- 48 h postoperatively
Methodological detailsdouble-blind, placebo-controlled, superiority, multicentre, Two arthroplasty centres in Denmark, November 2021 to March 2024
- Double-blind
- Placebo-controlled
- Superiority
- Multicentre
- Two arthroplasty centres in Denmark, November 2021 to March 2024
Primary result
As reported in the abstract
48 h
Odds ratio
0.48
95% CI 0.20–1.16
P = 0.100
By group
Dexamethasone vs Placebo
OR 0.48 (95% CI 0.20–1.16); P = 0.100
Secondary outcomes
Mean
| Outcome | Dexamethasone | Placebo | P value |
|---|---|---|---|
| VAS during walking · 48 h | 43 (SD 21) | 51 (SD 22) | P = 0.051 |
Secondary pain outcomes and rescue analgesic use
- No differences between the groups
Original publication
Repeat-dose dexamethasone to prevent pain relapse after total knee arthroplasty in high-pain-response patients: A randomised, double-blind, placebo-controlled superiority trial. Eur J Anaesthesiol. Published 14 May 2025. doi:10.
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