The efficacy and safety of dexamethasone for pain management after total knee arthroplasty: A systematic review and meta-analysis.

OBJECTIVE: To evaluate the clinical outcomes of dexamethasone versus placebo for pain control in patients undergoing total knee arthroplasty (TKA).

METHODS: The electronic databases include PubMed, Medline, Embase, Web of Science and the Cochrane Library from inception to February, 2018. Two reviewers abstracted visual analogue scale (VAS), total narcotic use, length of stay, and adverse effects. Data were using fixed-effects or random-effects models with weighted mean differences and odds ratio for continuous and dichotomous variables, respectively. STATA 14.0 was used to perform the meta-analysis.

RESULTS: Four studies encompassing 496 participants were retrieved for this meta-analysis. The present meta-analysis revealed that use of dexamethasone was associated with a significant reduction of pain score and total narcotic use. There were significant differences between groups in terms of adverse effects between groups.

CONCLUSION: Dexamethasone decreases pain scores within 48 h postoperatively and is associated with significantly reduced narcotic consumption. Dexamethasone as an analgesic therapy appears to be a safe in patients undergoing TKA.