Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial
Background and purpose: Periacetabular osteotomy (PAO) for hip dysplasia is associated with intensive pain and high opioid consumption. High doses of dexamethasone may reduce this. We aimed to compare the effect of 1 or 2 doses of dexamethasone 24 mg, relative to placebo, on postoperative morphine...
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Medical Journals Sweden
2025-06-01
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| Series: | Acta Orthopaedica |
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| Online Access: | https://actaorthop.org/actao/article/view/43903 |
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| author | Viktoria Lindberg-Larsen Martin Lindberg-Larsen Ole Ovesen Stine T Zwisler Peter Lindholm Stine Hebsgaard Robin Christensen Søren Overgaard |
| author_facet | Viktoria Lindberg-Larsen Martin Lindberg-Larsen Ole Ovesen Stine T Zwisler Peter Lindholm Stine Hebsgaard Robin Christensen Søren Overgaard |
| author_sort | Viktoria Lindberg-Larsen |
| collection | DOAJ |
| description |
Background and purpose: Periacetabular osteotomy (PAO) for hip dysplasia is associated with intensive pain and high opioid consumption. High doses of dexamethasone may reduce this. We aimed to compare the effect of 1 or 2 doses of dexamethasone 24 mg, relative to placebo, on postoperative morphine consumption after PAO.
Methods: A 3-group, randomized, double-blind, placebo-controlled trial was undertaken on patients ≥ 18 years, undergoing PAO (ClinicalTrials.gov: NCT03874936). Randomization Group A received 1 preoperative dose of dexamethasone 24 mg and placebo 24 hours later; Group B received 1 dose of intravenous dexamethasone 24 mg preoperatively and a repeated dose 24 hours postoperatively; and Group C received placebo at both time points. The primary endpoint was the difference in least squares mean cumulative postoperative morphine consumption between the combined dexamethasone groups and placebo within 48 hours from baseline. Key secondary outcomes included postoperative pain intensity, nausea and vomiting, antiemetic consumption and Timed Up and Go at 24 and 48 hours postoperatively, and cumulative morphine consumption from 48 hours to day 14 post-operation.
Results: 90 patients were randomized to dexamethasone groups (n = 60) and placebo (n = 30); 58 and 28, respectively, completed the trial. Mean age was 31 years and 71 (79%) were females. In the combined dexamethasone group the mean cumulated postoperative morphine consumption within 48 hours was 92 mg vs 95 mg in the placebo group, corresponding to a between-group difference of –3 mg (95% confidence interval –27 to 21; P = 0.8). There were no differences observed between groups for any of the secondary outcomes.
Conclusion: High-dose dexamethasone did not reduce postoperative morphine use or improve any of the secondary outcomes after PAO.
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| format | Article |
| id | doaj-art-b7ecc11977724bc5b9d0b0dfbe31aa1c |
| institution | OA Journals |
| issn | 1745-3674 1745-3682 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj-art-b7ecc11977724bc5b9d0b0dfbe31aa1c2025-08-20T02:00:13ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822025-06-019610.2340/17453674.2025.43903Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trialViktoria Lindberg-Larsen0Martin Lindberg-Larsen 1https://orcid.org/0000-0002-4483-677XOle Ovesen2Stine T Zwisler3Peter Lindholm4Stine Hebsgaard5Robin Christensen6https://orcid.org/0000-0002-6600-0631Søren Overgaard7https://orcid.org/0000-0001-6829-4787Department of Anesthesiology and Intensive Care Medicine, Odense University Hospital, Odense; Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, DenmarkDepartment of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense; Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, DenmarkDepartment of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense, DenmarkDepartment of Anesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, DenmarkDepartment of Anesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, DenmarkDepartment of Anesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, DenmarkSection for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, DenmarkDepartment of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense; Department of Orthopedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark Background and purpose: Periacetabular osteotomy (PAO) for hip dysplasia is associated with intensive pain and high opioid consumption. High doses of dexamethasone may reduce this. We aimed to compare the effect of 1 or 2 doses of dexamethasone 24 mg, relative to placebo, on postoperative morphine consumption after PAO. Methods: A 3-group, randomized, double-blind, placebo-controlled trial was undertaken on patients ≥ 18 years, undergoing PAO (ClinicalTrials.gov: NCT03874936). Randomization Group A received 1 preoperative dose of dexamethasone 24 mg and placebo 24 hours later; Group B received 1 dose of intravenous dexamethasone 24 mg preoperatively and a repeated dose 24 hours postoperatively; and Group C received placebo at both time points. The primary endpoint was the difference in least squares mean cumulative postoperative morphine consumption between the combined dexamethasone groups and placebo within 48 hours from baseline. Key secondary outcomes included postoperative pain intensity, nausea and vomiting, antiemetic consumption and Timed Up and Go at 24 and 48 hours postoperatively, and cumulative morphine consumption from 48 hours to day 14 post-operation. Results: 90 patients were randomized to dexamethasone groups (n = 60) and placebo (n = 30); 58 and 28, respectively, completed the trial. Mean age was 31 years and 71 (79%) were females. In the combined dexamethasone group the mean cumulated postoperative morphine consumption within 48 hours was 92 mg vs 95 mg in the placebo group, corresponding to a between-group difference of –3 mg (95% confidence interval –27 to 21; P = 0.8). There were no differences observed between groups for any of the secondary outcomes. Conclusion: High-dose dexamethasone did not reduce postoperative morphine use or improve any of the secondary outcomes after PAO. https://actaorthop.org/actao/article/view/43903HipPelvis and acetabulum |
| spellingShingle | Viktoria Lindberg-Larsen Martin Lindberg-Larsen Ole Ovesen Stine T Zwisler Peter Lindholm Stine Hebsgaard Robin Christensen Søren Overgaard Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial Acta Orthopaedica Hip Pelvis and acetabulum |
| title | Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial |
| title_full | Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial |
| title_fullStr | Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial |
| title_full_unstemmed | Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial |
| title_short | Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial |
| title_sort | effect of high dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia a randomized double blind placebo controlled single center trial |
| topic | Hip Pelvis and acetabulum |
| url | https://actaorthop.org/actao/article/view/43903 |
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