{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:01:13Z","timestamp":1791644473947,"version":"4.3.4"},"reference-count":21,"publisher":"Open Medical Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Effective management of postoperative pain is essential for promoting recovery and improving overall patient outcomes after total knee arthroplasty (TKA). Intravenous corticosteroids, especially dexamethasone, have become increasingly popular due to their strong anti-inflammatory effects, which can enhance pain control while minimizing side effects. However, the optimal dosing strategy for dexamethasone remains unclear, as most studies have primarily focused on fixed high doses.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This retrospective case-matched study aimed to evaluate the effectiveness of weight-based low-dose intravenous dexamethasone (0.1 mg\/kg) in managing postoperative pain following TKA.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Patients who underwent unilateral TKA for primary osteoarthritis were retrospectively analyzed and divided into two cohorts based on the timing of their surgery. The control group, consisting of patients who underwent TKA between March 2019 and November 2020, did not receive dexamethasone. In contrast, patients operated on between December 2020 and May 2022 received a preoperative weight-based dose of 0.1 mg\/kg intravenous dexamethasone. Postoperative pain was assessed using the Verbal Numerical Rating Scale (VNRS), and fentanyl consumption was recorded over the first 72 hours postoperatively.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The dexamethasone group demonstrated significantly lower pain scores at all measured intervals up to 60 hours postoperatively (p < 0.05) compared to the control group. Additionally, patients receiving dexamethasone required significantly less fentanyl in the first 24 hours and had lower cumulative fentanyl consumption over the entire 72-hour postoperative period (p < 0.001). There were no significant differences between the two groups in terms of hospital stay, deep infection rates, or other complications.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Weight-based low-dose dexamethasone (0.1 mg\/kg) appears to be an effective strategy for reducing postoperative pain and opioid use following TKA.<\/jats:p>\n <\/jats:sec>","DOI":"10.52965\/001c.143092","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T15:26:10Z","timestamp":1755703570000},"source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of Weight-Based Low-Dose Intravenous Dexamethasone for Pain Management Following Total Knee Arthroplasty: A Retrospective Case-Matched Study."],"prefix":"10.52965","volume":"17","author":[{"given":"Varah","family":"Yuenyongviwat","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0575ycz84","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peranut","family":"Kitjakrancharoensin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0575ycz84","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirathit","family":"Anusitviwat","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0575ycz84","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khanin","family":"Iamthanaporn","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0575ycz84","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30777","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"10225536241256554","DOI":"10.1177\/10225536241256554","article-title":"Intraoperative intravenous versus periarticular injection of glucocorticoids in improving clinical outcomes after total knee arthroplasty: A prospective, randomized and controlled study","volume":"32","author":"Q. Li","year":"2024","journal-title":"J Orthop Surg Hong Kong"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2213","DOI":"10.1016\/j.arth.2024.04.030","article-title":"Effects of Dexamethasone on Postoperative Glycemic Control in Patients After Primary Total Joint Arthroplasty: A Randomized Double-Blind Controlled Trial","volume":"39","author":"X.-Y. Liu","year":"2024","journal-title":"J Arthroplasty"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1111\/aas.14377","article-title":"Associations of dexamethasone's effect on morphine consumption after total knee arthroplasty-Subgroup analyses","volume":"68","author":"K. S. Gasbjerg","year":"2024","journal-title":"Acta Anaesthesiol Scand"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1016\/j.arth.2022.01.079","article-title":"Does Nefopam Provide Analgesic Effect and Reduce Morphine Consumption After Primary Total Knee Arthroplasty? A Prospective, Double-Blind, Randomized Controlled Trial","volume":"37","author":"P. Pinsornsak","year":"2022","journal-title":"J Arthroplasty"},{"key":"ref5","first-page":"E169","article-title":"Effect of Intravenous Dexamethasone on Postoperative Pain in Patients Undergoing Total Knee Arthroplasty: A Systematic Review and Meta-Analysis","volume":"25","author":"S. Liang","year":"2022","journal-title":"Pain Physician"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.bja.2021.10.001","article-title":"High-dose steroids in high pain responders undergoing total knee arthroplasty: a randomised double-blind trial","volume":"128","author":"N. I. Nielsen","year":"2022","journal-title":"Br J Anaesth"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1007\/s00402-022-04356-x","article-title":"The application of low-dose dexamethasone in total knee arthroplasty: finding out the best route and dosage schedule","volume":"143","author":"M. K. Saini","year":"2023","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.arth.2019.09.002","article-title":"Intravenous Dexamethasone Injection Reduces Pain From 12 to 21 Hours After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled Trial","volume":"35","author":"N. Tammachote","year":"2020","journal-title":"J Arthroplasty"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"3010","DOI":"10.1007\/s11999-013-3032-5","article-title":"Preemptive low-dose dexamethasone reduces postoperative emesis and pain after TKA: a randomized controlled study","volume":"471","author":"I. J. Koh","year":"2013","journal-title":"Clin Orthop"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.arth.2018.12.014","article-title":"The Effects of Peri-Operative Dexamethasone on Patients Undergoing Total Hip or Knee Arthroplasty: Is It Safe for Diabetics?","volume":"34","author":"B. M. Godshaw","year":"2019","journal-title":"J Arthroplasty"},{"key":"ref11","first-page":"704","article-title":"A Randomized Double-Blind Prospective Study Comparing the Efficacy of Subperiosteal and Periarticular Injections of a Local Anesthetic for Postoperative Pain Management after Total Knee Arthroplasty","volume":"11","author":"R. Minaei","year":"2023","journal-title":"Arch Bone Jt Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1007\/s00264-018-4156-8","article-title":"Infection safety of dexamethasone in total hip and total knee arthroplasty: a study of eighteen thousand, eight hundred and seventy two operations","volume":"43","author":"M. A. Vuorinen","year":"2019","journal-title":"Int Orthop"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"3448","DOI":"10.1016\/j.arth.2018.06.031","article-title":"Multiple Doses of Perioperative Dexamethasone Further Improve Clinical Outcomes After Total Knee Arthroplasty: A Prospective, Randomized, Controlled Study","volume":"33","author":"H. Xu","year":"2018","journal-title":"J Arthroplasty"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e34895","DOI":"10.1097\/MD.0000000000034895","article-title":"The efficacy and safety of duloxetine for the treatment of patients after TKA or THA: A systematic review and meta-analysis","volume":"102","author":"Y. Zhou","year":"2023","journal-title":"Medicine (Baltimore)"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006805","article-title":"What Is the Role of a Periarticular Injection for Knee Arthroplasty Patients Receiving a Multimodal Analgesia Regimen Incorporating Adductor Canal and Infiltration Between the Popliteal Artery and Capsule of the Knee Blocks? A Randomized Blinded Placebo-Controlled Noninferiority Trial","author":"J. T. YaDeau","year":"2024","journal-title":"Anesth Analg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"10225536231225758","DOI":"10.1177\/10225536231225758","article-title":"Superior analgesic efficacy of preemptive low-dose ketorolac compared with parecoxib after total knee arthroplasty: A retrospective propensity score matching study","volume":"32","author":"K. Iamthanaporn","year":"2024","journal-title":"J Orthop Surg Hong Kong"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e33874","DOI":"10.7759\/cureus.33874","article-title":"Efficacy of Corticosteroid Addition to a Periarticular Cocktail Injection to Counteract Nausea and Vomiting After Total Knee Arthroplasty","volume":"15","author":"T. Ebihara","year":"2023","journal-title":"Cureus"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.ijsu.2020.07.065","article-title":"The optimal dosage, route and timing of glucocorticoids administration for improving knee function, pain and inflammation in primary total knee arthroplasty: A systematic review and network meta-analysis of 34 randomized trials","volume":"82","author":"L. Wu","year":"2020","journal-title":"Int J Surg Lond Engl"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"319","DOI":"10.2106\/JBJS.20.01153","article-title":"Comparison of Intravenous and Periarticular Administration of Corticosteroids in Total Knee Arthroplasty: A Prospective, Randomized Controlled Study","volume":"103","author":"K. Hatayama","year":"2021","journal-title":"J Bone Joint Surg Am"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.arth.2019.09.002","article-title":"Intravenous Dexamethasone Injection Reduces Pain From 12 to 21 Hours After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled Trial","volume":"35","author":"N. Tammachote","year":"2020","journal-title":"J Arthroplasty"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1111\/aas.14319","article-title":"Prolonged effects of dexamethasone following total knee arthroplasty: A pre-planned sub-study of the DEX-2-TKA trial","volume":"68","author":"C. B. Derby","year":"2024","journal-title":"Acta Anaesthesiol Scand"}],"container-title":["Orthopedic Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/143092-efficacy-of-weight-based-low-dose-intravenous-dexamethasone-for-pain-management-following-total-knee-arthroplasty-a-retrospective-case-matched-study","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T00:59:46Z","timestamp":1761440386000},"score":1,"resource":{"primary":{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/143092-efficacy-of-weight-based-low-dose-intravenous-dexamethasone-for-pain-management-following-total-knee-arthroplasty-a-retrospective-case-matched-study"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":21,"URL":"https:\/\/doi.org\/10.52965\/001c.143092","relation":{},"ISSN":["2035-8164"],"issn-type":[{"value":"2035-8164","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,20]]}}}