Study: Repeat Dose of Perioperative Dexamethasone can be ver
This randomized controlled trial compared postoperative pain and tramadol requirement in patients undergoing unilateral primary THA who received one versus two perioperative doses of dexamethasone.

Patients consented to undergo blinded, simple randomization to either one or two perioperative doses of 8-mg intravenous dexamethasone. Pain was evaluated with visual analogue scale at 8, 16 and 24 hours postoperatively and with tramadol requirement. Secondary outcomes included postoperative nausea and vomiting (PONV), time to ambulation, and length of stay (LOS).

--Age, body mass index; gender and history of diabetes were similar between groups.

--Pain was higher at 16 and 24 hours postoperatively in the 1D-group patients.

--1D-group patients had significantly more tramadol consumption, as well as PONV.

--55 patients in the 2D-group and 32 in the 1D-group ambulated on postoperative day 0. 58 patients in the 2D-group and 37 in the 1D-group were discharged on postoperative day 1.

Finally, a second dosage of dexamethasone administered 8 hours after primary THA dramatically reduced pain, tramadol use, delay to ambulation, and LOS.