Dexamethasone Application Research in the Perioperative Period of Total Hip Arthroplasty in Patients with Type 2 Diabetes

Liu Wenhui; Li Zhengliang; Li Fulin; Huang Xiao; Huang Wenwen; Yin Dong

Abstract：Objective To assess the clinical effectiveness and safety of perioperative intravenous dexamethasone(Dexa)administration in type 2 diabetes patients undergoing total hip arthroplasty(TH A).Methods Sixty patients with type 2 diabetes who received THA in the People's Hospital of Guangxi Zhuang Autonomous Region from September 2021 to November 2023 were selected and divided into a Dexa group and a control group using a prospective,single-blind randomized control method.The Dexa group comprised 30 patients,including 16 males and 14 females,with an age of 65.5(60.8,72.0)years.The control group included 30 patients,comprising 15 males and 15 females,with an age of 60.33(55.0,67.5)years.White blood cell count(WBC),C-reactive protein(CRP),visual analogue scale(VAS),blood glucose levels,nausea,vomiting,the need for antiemetic and analgesic drugs,and postoperative complications were observed in the study.Results(1)On the second and third postoperative days,the WBC count in the control group was significantly higher than that in the Dexa group(P＜0.05).(2)From the first to the third postoperative day,the CRP level in the Dexa group was significantly lower than that in the control group(P＜0.05).(3)On the first postoperative day,the blood glucose level in the Dexa group was significantly higher than that in the control group(P＜0.01).(4)The highest blood glucose level in the Dexa group was significantly higher than that in the control group on day 1 after surgery(P=0.031).On the day of surgery,the second day after surgery,and the third day after surgery,there was no significant difference in the maximum blood glucose level between the two groups(P＞0.05).(5)During the first two postoperative days,the VAS pain scores at rest and during activity were significantly lower in the Dexa group compared to the control group(P＜0.05).(6)The number of patients in the Dexa group who required tramadol hydrochloride injection and metoclopramide hydrochloride injection,as well as the total amount of these drugs within 3 days after surgery,were significantly lower than those in the control group(P＜0.05).(7)The Dexa group had a significantly lower incidence of postoperative nausea and vomiting(PONV)and nausea compared to the control group,with statistical significance(P＜0.05).(8)The hospital stay duration in the Dexa group was significantly shorter,with a statistically significant difference(P=0.002)compared to the control group.(9)No significant differences were observed in the rehospitalization rate within 90 days postoperatively and the incidence of surgical complications between the two groups(P＞0.05).Conclusion In type 2 diabetic patients undergoing total hip arthroplasty(THA),intravenous administration of Dexa has a favorable impact by efficiently suppressing postoperative inflammation,lowering pain scores,and decreasing the occurrence of postoperative nausea and vomiting.This treatment also results in reduced reliance on antiemetic and analgesic medications,as well as a shortened hospital stay.Despite a temporary rise in postoperative blood glucose levels,Dexa administration does not significantly increase the risk of postoperative complications.