Low-dose Dexamethasone in the Prevention of Postoperative Nausea and Vomiting After Total Joint Arthroplasty: a Retrospective Study

Background: To investigate the clinical efficacy and safety of prophylactic low-dose dexamethasone for postoperative nausea and vomiting (PONV) after total joint arthroplasty. Methods: a total of 100 patients who underwent primary total knee or hip arthroplasty were enrolled. Patients were divided into placebo group (received 1 ml normal saline), and Dexa group (received 5 mg dexamethasone). The incidence of PONV was recorded and divided into 4 levels for statistical comparison. The occurrences of postoperative complications, the numerical rating scales for pain, the consumption of analgesic and antiemetic rescue, and the patient satisfaction rate were counted and compared. Results: In the Dexa group, patients had a lower incidence of level Ⅲ or higher PONV than those in the placebo group (p<0.05), as well as the amount of additional antiemetic drugs. The pain level and consumption of analgesics were similar in the two groups. No delayed wound healing or gastrointestinal hemorrhage was observed in either group. One patient in the placebo group got early surgical site infection occurred with no statistical significance. Patients in Dexa group had a higher subjective satisfaction rate. Conclusion: The prophylactic application of 5 mg dexamethasone during induction of anesthesia can effectively reduce the incidence of severe PONV after the initial total joint replacement and the consumption of antiemetic drugs, improve the patient's care experience, and will not bring significant clinical harm.