Perioperative intravenous dexamethasone shortened hospital stay (5.67 vs. 6.70 days) and reduced the incidence of postoperative nausea and vomiting in patients with type 2 diabetes mellitus undergoing total hip arthroplasty.
RCT (n=60)
Single-blind
Computer-generated random number sequence with variable block sizes
No
Does perioperative intravenous dexamethasone improve postoperative pain and recovery outcomes in patients with type 2 diabetes mellitus undergoing total hip arthroplasty?
Perioperative intravenous dexamethasone improves early recovery outcomes, including pain and PONV, and shortens hospital stay in T2DM patients undergoing THA, with only transient and manageable hyperglycemia.
Absolute Event Rate: 5.67% vs 6.7%
p-value: p=0.002
This study aimed to evaluate the efficacy and safety of perioperative intravenous dexamethasone (Dexa) in patients with type 2 diabetes mellitus (T2DM) undergoing total hip arthroplasty (THA). In this prospective, single-blind randomized trial (Registration No.: MR-45-23-047982; Registration Date: December 7, 2023), 60 T2DM patients undergoing THA were assigned to either the Dexa or control group. Outcomes included white blood cell count (WBC), C-reactive protein (CRP), visual analogue scale (VAS) scores, blood glucose, nausea and vomiting, medication requirements, complications, and hospital stay. Compared with controls, the Dexa group had lower WBC on postoperative days 2 ~ 3 (day 2: 9.20 ± 1.28 vs.10.56 ± 2.34 × 109/L, P = 0.007; day 3: 8.02 ± 1.34 vs. 9.22 ± 1.49 × 109/L, P = 0.002)and reduced CRP on days 1 ~ 3 (day 1: 38.20 vs. 63.50 mg/L, P = 0.040; day 2: 86.00 vs. 101.50 mg/L, P = 0.010; day 3: 78.00 vs. 95.20 mg/L, P = 0.044). Transient hyperglycemia was observed in the Dexa group on postoperative day 1, with higher median blood glucose (8.90 vs. 8.35 mmol/L, P 0.05). Perioperative Dexa administration improves early recovery outcomes in patients with T2DM undergoing THA without compromising short-term safety, although it may cause transient hyperglycemia. However, the relatively small sample size, limited follow-up period, and lack of systematic evaluation of potential complications highlight the need for larger, longer-term studies to further strengthen these observations.
Liu et al. (2026) conducted an RCT in Type 2 diabetes mellitus undergoing total hip arthroplasty (n=60). Intravenous dexamethasone vs. Normal saline was evaluated on Hospital stay (days) (p=0.002). Perioperative intravenous dexamethasone shortened hospital stay (5.67 vs. 6.70 days) and reduced the incidence of postoperative nausea and vomiting in patients with type 2 diabetes mellitus undergoing total hip arthroplasty.