Podium (Sports) 07

Low perioperative dexamethasone improves postoperative pain after anterior cruciate ligament reconstruction

Kavin Khatri, MD
Consultant All India Institute of Medical Sciences (AIIMS) Bathinda, India

Introduction: Postoperative pain following anterior cruciate ligament reconstruction remains an important challenge. Steroids are used in various surgical procedures to decrease postoperative nausea, vomiting and pain. However, few studies had studied the effect of systemic administration of steroids in controlling postoperative pain after anterior cruciate ligament surgery. Method: We had conducted a prospective randomized trial with 109 patients divided in two groups to determine if administration of dexamethasone in the perioperative period improves pain in the postoperative period. The patients in one group were given the first dose of 10 mg of intravenous dexamethasone intravenously intraoperatively and the second dose on shifting of patient to inpatient department. In another (Placebo) group, the patients were administered normal saline in the perioperative period in a similar manner. 

Result: Postoperative pain was significantly lower in the dexamethasone group at rest and on walking (p<0.001) for the first 24 hours after surgical procedure. Subsequently the VAS pain scores were almost similar in both groups at 48 and 72 hours. The administration of dexamethasone resulted in less requirement of antiemetic and rescue analgesia medication There was no difference in range of motion and wound complications rate during the follow up period at six months. No adverse side effect like osteonecrosis of hip was reported. 

Conclusion: The pain following anterior cruciate ligament reconstruction is severe during the first 24 hours and perioperative administration of dexamethasone can decrease the postoperative pain substantially.