Loading…
Combined Application of Dexamethasone and Tranexamic Acid to Reduce the Postoperative Inflammatory Response and Improve Functional Outcomes in Total Hip Arthroplasty
Objective To evaluate the efficacy and safety of combined use of tranexamic acid (TXA) and dexamethasone (DEX) for anti‐inflammatory and clinical outcomes after total hip arthroplasty (THA). Methods A total of 100 patients were included in this randomized, controlled study. Patients in the TXA + DEX...
Saved in:
| Published in: | Orthopaedic surgery 2020-04, Vol.12 (2), p.582-588 |
|---|---|
| Main Authors: | , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c5714-777f12db301d8d3f3c90e35ec938c1a9ac671dfaf1f1179feb230260a8b5cf133 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c5714-777f12db301d8d3f3c90e35ec938c1a9ac671dfaf1f1179feb230260a8b5cf133 |
| container_end_page | 588 |
| container_issue | 2 |
| container_start_page | 582 |
| container_title | Orthopaedic surgery |
| container_volume | 12 |
| creator | An, Yu‐zhang Xu, Ming‐deng An, Yu‐cheng Liu, Huan Zheng, Ming Jiang, Dian‐ming |
| description | Objective
To evaluate the efficacy and safety of combined use of tranexamic acid (TXA) and dexamethasone (DEX) for anti‐inflammatory and clinical outcomes after total hip arthroplasty (THA).
Methods
A total of 100 patients were included in this randomized, controlled study. Patients in the TXA + DEX group were administered TXA at a dose of 15 mg/kg, which was repeated 3 h after THA, and received 20 mg DEX. In contrast, patients in the TXA group were administered TXA at a dose of 15 mg/kg, which was repeated at 3 h postoperatively. C‐reactive protein (CRP), interleukin‐6 (IL‐6) and pain levels, incidence of postoperative nausea and vomiting (PONV), total blood loss and transfusion rates, postoperative fatigue, range of motion (ROM), length of hospital stay (LOS), analgesic rescue and antiemetic rescue consumption, and complications were compared in both groups.
Results
The CRP and IL‐6 levels were lower in the TXA + DEX group than in the TXA group (all P |
| doi_str_mv | 10.1111/os.12664 |
| format | article |
| fullrecord | <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_446db9d3ae8e4f018969195df4a036fe</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A732928442</galeid><doaj_id>oai_doaj_org_article_446db9d3ae8e4f018969195df4a036fe</doaj_id><sourcerecordid>A732928442</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5714-777f12db301d8d3f3c90e35ec938c1a9ac671dfaf1f1179feb230260a8b5cf133</originalsourceid><addsrcrecordid>eNp1kt1u0zAUgCMEYmMg8QiWuOEmxY6TOLlBqjrGKk0qgnJtOf5pXSU-wXYGfSDeE3eZJiqBfWHr-DvfObKdZW8JXpA0PkBYkKKuy2fZJWEVy1lTk-dP-4peZK9COGBct5Sxl9kFLWjJMK4us98rGDrrtELLceytFNGCQ2DQtf4lBh33IoDTSDiFtl64U9BKtJRWoQjoq1aT1CjuNfoCIcKofRLca7R2phfDICL4Y6LCCC7MlvUwekjEzeTkqZbo0WaKEgYdkHVoCzFFbu2Ilj7uPYy9CPH4OnthRB_0m8f1Kvt-82m7us3vNp_Xq-VdLitGypwxZkihOoqJahQ1VLZY00rLljaSiFbImhFlhCGGENYa3RUUFzUWTVdJQyi9ytazV4E48NHbQfgjB2H5QwD8jgsfrew1L8tada2iQje6NJg0bd2StlKmFJjWRifXx9k1Tt2gldQuetGfSc9PnN3zHdxzllyYVknw7lHg4cekQ-QHmHy6sMAL2lYlTQX_onYidWWdgSSTgw2SLxkt2qIpyyJRi39QaSqd3jO9sLEpfpbwfk6QHkLw2jw1TjA__TkOgT_8uYTmM_ozOY7_5fjm28z_Aa0d2Go</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2395436915</pqid></control><display><type>article</type><title>Combined Application of Dexamethasone and Tranexamic Acid to Reduce the Postoperative Inflammatory Response and Improve Functional Outcomes in Total Hip Arthroplasty</title><source>Publicly Available Content Database</source><source>Wiley Open Access</source><source>PubMed Central</source><creator>An, Yu‐zhang ; Xu, Ming‐deng ; An, Yu‐cheng ; Liu, Huan ; Zheng, Ming ; Jiang, Dian‐ming</creator><creatorcontrib>An, Yu‐zhang ; Xu, Ming‐deng ; An, Yu‐cheng ; Liu, Huan ; Zheng, Ming ; Jiang, Dian‐ming</creatorcontrib><description>Objective
To evaluate the efficacy and safety of combined use of tranexamic acid (TXA) and dexamethasone (DEX) for anti‐inflammatory and clinical outcomes after total hip arthroplasty (THA).
Methods
A total of 100 patients were included in this randomized, controlled study. Patients in the TXA + DEX group were administered TXA at a dose of 15 mg/kg, which was repeated 3 h after THA, and received 20 mg DEX. In contrast, patients in the TXA group were administered TXA at a dose of 15 mg/kg, which was repeated at 3 h postoperatively. C‐reactive protein (CRP), interleukin‐6 (IL‐6) and pain levels, incidence of postoperative nausea and vomiting (PONV), total blood loss and transfusion rates, postoperative fatigue, range of motion (ROM), length of hospital stay (LOS), analgesic rescue and antiemetic rescue consumption, and complications were compared in both groups.
Results
The CRP and IL‐6 levels were lower in the TXA + DEX group than in the TXA group (all P < 0.001) at 24 h, 48 h, and 72 h postoperatively. Patients in the TXA + DEX group had lower pain scores at rest and walking at 24 h postoperatively (all P < 0.001). In the TXA + DEX group, the incidence of PONV was lower (P = 0.005), postoperative fatigue (P < 0.001) was reduced, and analgesia and antiemetic rescue consumption were also reduced. The total blood loss, transfusion rate, LOS and hip ROM were similar in the two groups. There was no thrombosis, infection, or gastrointestinal bleeding in either group.
Conclusion
Compared to TXA alone, the combination of TXA + DEX can reduce postoperative inflammatory response, relieve pain, and reduce PONV and fatigue, without increasing the risk of complications. Therefore, the present study suggested that the combination of TXA + DEX is an effective and safe accelerated rehabilitation strategy for patients receiving primary unilateral THA.</description><identifier>ISSN: 1757-7853</identifier><identifier>EISSN: 1757-7861</identifier><identifier>DOI: 10.1111/os.12664</identifier><identifier>PMID: 32347005</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Antifibrinolytic agents ; C-reactive protein ; Care and treatment ; Central nervous system depressants ; Clinical ; Clinical outcomes ; Dexamethasone ; Hip joint ; Joint replacement surgery ; Medical research ; Medicine, Experimental ; Nausea ; Pain ; Patient outcomes ; Postoperative period ; Steroids ; Surgical outcomes ; Total hip arthroplasty ; Tranexamic acid</subject><ispartof>Orthopaedic surgery, 2020-04, Vol.12 (2), p.582-588</ispartof><rights>2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.</rights><rights>COPYRIGHT 2020 John Wiley & Sons, Inc.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5714-777f12db301d8d3f3c90e35ec938c1a9ac671dfaf1f1179feb230260a8b5cf133</citedby><cites>FETCH-LOGICAL-c5714-777f12db301d8d3f3c90e35ec938c1a9ac671dfaf1f1179feb230260a8b5cf133</cites><orcidid>0000-0002-1938-9699</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189035/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189035/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11560,27922,27923,37010,46050,46474,53789,53791</link.rule.ids></links><search><creatorcontrib>An, Yu‐zhang</creatorcontrib><creatorcontrib>Xu, Ming‐deng</creatorcontrib><creatorcontrib>An, Yu‐cheng</creatorcontrib><creatorcontrib>Liu, Huan</creatorcontrib><creatorcontrib>Zheng, Ming</creatorcontrib><creatorcontrib>Jiang, Dian‐ming</creatorcontrib><title>Combined Application of Dexamethasone and Tranexamic Acid to Reduce the Postoperative Inflammatory Response and Improve Functional Outcomes in Total Hip Arthroplasty</title><title>Orthopaedic surgery</title><description>Objective
To evaluate the efficacy and safety of combined use of tranexamic acid (TXA) and dexamethasone (DEX) for anti‐inflammatory and clinical outcomes after total hip arthroplasty (THA).
Methods
A total of 100 patients were included in this randomized, controlled study. Patients in the TXA + DEX group were administered TXA at a dose of 15 mg/kg, which was repeated 3 h after THA, and received 20 mg DEX. In contrast, patients in the TXA group were administered TXA at a dose of 15 mg/kg, which was repeated at 3 h postoperatively. C‐reactive protein (CRP), interleukin‐6 (IL‐6) and pain levels, incidence of postoperative nausea and vomiting (PONV), total blood loss and transfusion rates, postoperative fatigue, range of motion (ROM), length of hospital stay (LOS), analgesic rescue and antiemetic rescue consumption, and complications were compared in both groups.
Results
The CRP and IL‐6 levels were lower in the TXA + DEX group than in the TXA group (all P < 0.001) at 24 h, 48 h, and 72 h postoperatively. Patients in the TXA + DEX group had lower pain scores at rest and walking at 24 h postoperatively (all P < 0.001). In the TXA + DEX group, the incidence of PONV was lower (P = 0.005), postoperative fatigue (P < 0.001) was reduced, and analgesia and antiemetic rescue consumption were also reduced. The total blood loss, transfusion rate, LOS and hip ROM were similar in the two groups. There was no thrombosis, infection, or gastrointestinal bleeding in either group.
Conclusion
Compared to TXA alone, the combination of TXA + DEX can reduce postoperative inflammatory response, relieve pain, and reduce PONV and fatigue, without increasing the risk of complications. Therefore, the present study suggested that the combination of TXA + DEX is an effective and safe accelerated rehabilitation strategy for patients receiving primary unilateral THA.</description><subject>Antifibrinolytic agents</subject><subject>C-reactive protein</subject><subject>Care and treatment</subject><subject>Central nervous system depressants</subject><subject>Clinical</subject><subject>Clinical outcomes</subject><subject>Dexamethasone</subject><subject>Hip joint</subject><subject>Joint replacement surgery</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Nausea</subject><subject>Pain</subject><subject>Patient outcomes</subject><subject>Postoperative period</subject><subject>Steroids</subject><subject>Surgical outcomes</subject><subject>Total hip arthroplasty</subject><subject>Tranexamic acid</subject><issn>1757-7853</issn><issn>1757-7861</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>DOA</sourceid><recordid>eNp1kt1u0zAUgCMEYmMg8QiWuOEmxY6TOLlBqjrGKk0qgnJtOf5pXSU-wXYGfSDeE3eZJiqBfWHr-DvfObKdZW8JXpA0PkBYkKKuy2fZJWEVy1lTk-dP-4peZK9COGBct5Sxl9kFLWjJMK4us98rGDrrtELLceytFNGCQ2DQtf4lBh33IoDTSDiFtl64U9BKtJRWoQjoq1aT1CjuNfoCIcKofRLca7R2phfDICL4Y6LCCC7MlvUwekjEzeTkqZbo0WaKEgYdkHVoCzFFbu2Ilj7uPYy9CPH4OnthRB_0m8f1Kvt-82m7us3vNp_Xq-VdLitGypwxZkihOoqJahQ1VLZY00rLljaSiFbImhFlhCGGENYa3RUUFzUWTVdJQyi9ytazV4E48NHbQfgjB2H5QwD8jgsfrew1L8tada2iQje6NJg0bd2StlKmFJjWRifXx9k1Tt2gldQuetGfSc9PnN3zHdxzllyYVknw7lHg4cekQ-QHmHy6sMAL2lYlTQX_onYidWWdgSSTgw2SLxkt2qIpyyJRi39QaSqd3jO9sLEpfpbwfk6QHkLw2jw1TjA__TkOgT_8uYTmM_ozOY7_5fjm28z_Aa0d2Go</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>An, Yu‐zhang</creator><creator>Xu, Ming‐deng</creator><creator>An, Yu‐cheng</creator><creator>Liu, Huan</creator><creator>Zheng, Ming</creator><creator>Jiang, Dian‐ming</creator><general>John Wiley & Sons Australia, Ltd</general><general>John Wiley & Sons, Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-1938-9699</orcidid></search><sort><creationdate>202004</creationdate><title>Combined Application of Dexamethasone and Tranexamic Acid to Reduce the Postoperative Inflammatory Response and Improve Functional Outcomes in Total Hip Arthroplasty</title><author>An, Yu‐zhang ; Xu, Ming‐deng ; An, Yu‐cheng ; Liu, Huan ; Zheng, Ming ; Jiang, Dian‐ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5714-777f12db301d8d3f3c90e35ec938c1a9ac671dfaf1f1179feb230260a8b5cf133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Antifibrinolytic agents</topic><topic>C-reactive protein</topic><topic>Care and treatment</topic><topic>Central nervous system depressants</topic><topic>Clinical</topic><topic>Clinical outcomes</topic><topic>Dexamethasone</topic><topic>Hip joint</topic><topic>Joint replacement surgery</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Nausea</topic><topic>Pain</topic><topic>Patient outcomes</topic><topic>Postoperative period</topic><topic>Steroids</topic><topic>Surgical outcomes</topic><topic>Total hip arthroplasty</topic><topic>Tranexamic acid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>An, Yu‐zhang</creatorcontrib><creatorcontrib>Xu, Ming‐deng</creatorcontrib><creatorcontrib>An, Yu‐cheng</creatorcontrib><creatorcontrib>Liu, Huan</creatorcontrib><creatorcontrib>Zheng, Ming</creatorcontrib><creatorcontrib>Jiang, Dian‐ming</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley Online Library Free Content</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Orthopaedic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>An, Yu‐zhang</au><au>Xu, Ming‐deng</au><au>An, Yu‐cheng</au><au>Liu, Huan</au><au>Zheng, Ming</au><au>Jiang, Dian‐ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combined Application of Dexamethasone and Tranexamic Acid to Reduce the Postoperative Inflammatory Response and Improve Functional Outcomes in Total Hip Arthroplasty</atitle><jtitle>Orthopaedic surgery</jtitle><date>2020-04</date><risdate>2020</risdate><volume>12</volume><issue>2</issue><spage>582</spage><epage>588</epage><pages>582-588</pages><issn>1757-7853</issn><eissn>1757-7861</eissn><abstract>Objective
To evaluate the efficacy and safety of combined use of tranexamic acid (TXA) and dexamethasone (DEX) for anti‐inflammatory and clinical outcomes after total hip arthroplasty (THA).
Methods
A total of 100 patients were included in this randomized, controlled study. Patients in the TXA + DEX group were administered TXA at a dose of 15 mg/kg, which was repeated 3 h after THA, and received 20 mg DEX. In contrast, patients in the TXA group were administered TXA at a dose of 15 mg/kg, which was repeated at 3 h postoperatively. C‐reactive protein (CRP), interleukin‐6 (IL‐6) and pain levels, incidence of postoperative nausea and vomiting (PONV), total blood loss and transfusion rates, postoperative fatigue, range of motion (ROM), length of hospital stay (LOS), analgesic rescue and antiemetic rescue consumption, and complications were compared in both groups.
Results
The CRP and IL‐6 levels were lower in the TXA + DEX group than in the TXA group (all P < 0.001) at 24 h, 48 h, and 72 h postoperatively. Patients in the TXA + DEX group had lower pain scores at rest and walking at 24 h postoperatively (all P < 0.001). In the TXA + DEX group, the incidence of PONV was lower (P = 0.005), postoperative fatigue (P < 0.001) was reduced, and analgesia and antiemetic rescue consumption were also reduced. The total blood loss, transfusion rate, LOS and hip ROM were similar in the two groups. There was no thrombosis, infection, or gastrointestinal bleeding in either group.
Conclusion
Compared to TXA alone, the combination of TXA + DEX can reduce postoperative inflammatory response, relieve pain, and reduce PONV and fatigue, without increasing the risk of complications. Therefore, the present study suggested that the combination of TXA + DEX is an effective and safe accelerated rehabilitation strategy for patients receiving primary unilateral THA.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>32347005</pmid><doi>10.1111/os.12664</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1938-9699</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1757-7853 |
| ispartof | Orthopaedic surgery, 2020-04, Vol.12 (2), p.582-588 |
| issn | 1757-7853 1757-7861 |
| language | eng |
| recordid | cdi_doaj_primary_oai_doaj_org_article_446db9d3ae8e4f018969195df4a036fe |
| source | Publicly Available Content Database; Wiley Open Access; PubMed Central |
| subjects | Antifibrinolytic agents C-reactive protein Care and treatment Central nervous system depressants Clinical Clinical outcomes Dexamethasone Hip joint Joint replacement surgery Medical research Medicine, Experimental Nausea Pain Patient outcomes Postoperative period Steroids Surgical outcomes Total hip arthroplasty Tranexamic acid |
| title | Combined Application of Dexamethasone and Tranexamic Acid to Reduce the Postoperative Inflammatory Response and Improve Functional Outcomes in Total Hip Arthroplasty |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-09T13%3A40%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Combined%20Application%20of%20Dexamethasone%20and%20Tranexamic%20Acid%20to%20Reduce%20the%20Postoperative%20Inflammatory%20Response%20and%20Improve%20Functional%20Outcomes%20in%20Total%20Hip%20Arthroplasty&rft.jtitle=Orthopaedic%20surgery&rft.au=An,%20Yu%E2%80%90zhang&rft.date=2020-04&rft.volume=12&rft.issue=2&rft.spage=582&rft.epage=588&rft.pages=582-588&rft.issn=1757-7853&rft.eissn=1757-7861&rft_id=info:doi/10.1111/os.12664&rft_dat=%3Cgale_doaj_%3EA732928442%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c5714-777f12db301d8d3f3c90e35ec938c1a9ac671dfaf1f1179feb230260a8b5cf133%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2395436915&rft_id=info:pmid/32347005&rft_galeid=A732928442&rfr_iscdi=true |