What?
Danish researchers have found that taking a steroid called dexamethasone during and after a total knee replacement reduces the total amount of morphine required post-operatively.
During and 24 hours after a total knee replacement, patients were either given a dexamethasone injection or a placebo. Then, the total amount of morphine required in the first 48 hours post-op was measured. It was observed that those receiving a steroid injection used less morphine and therefore were presumed to have experienced less pain.
Why?
The researchers focused on total knee replacements, a common operation where morphine use is necessary for moderate or severe pain.
Having a joint replacement operation is painful. Therefore any means of reducing the amount of pain post-operatively is of clear benefit. This includes simply being in less pain, to allowing early mobilisation to get the new joint working.
After joint replacements, patients usually need to take morphine or similar drugs to reduce pain and allow early movement to move the joint. Morphine can come with its own side effects including constipation, itching and possibility of addiction. It is therefore important to reduce painkiller consumption in the period after an operation.
Steroids reduce inflammation in the body. In theory, reducing this inflammation in the joint will reduce the amount of post-operative pain. However, the way steroids work can also lead to a number of negative side effects, including poor wound-healing, high glucose and infection. Researchers looked into how often these negative outcomes occurred, alongside the positive outcomes of reduced pain and reduced painkiller intake.
How (does it affect you)?
This research only looked at total knee replacements, and is the first piece of evidence to support steroid use after a joint operation. Unfortunately this means a number of things:
- We cannot say whether the same is true for other common joint operations, e.g. hip replacements
- This research will take a long time to come into clinical practice
- It is a relatively small study with a number of limitations (that the researchers detail in their paper).
Even if you are about to undergo a knee replacement, this research won’t affect you… yet. But, this is a positive step for an operation that thousands of people undergo each year. The researchers showed reduced post-op pain, but also showed no change in infection or healing rates. There was only a mild increase seen in glucose levels in healthy, non-diabetic patients.
Overall, the study demonstrates a significant potential new technique to get people moving quicker after a joint operation. If you would like to read the paper, you can access it here.
If you’re worried about your wound after an operation like this, have a read of this great tip. But if you’re finding that you’re waiting too long for your operation, there may be another option.
As always, best wishes from myHSN.
