Effects And Safety Assessment Of Methylprednisolone On Postoperative Nausea And Vomiting And Pain After Total Knee Arthroplasty

Objective To evaluate the effects and safety assessment of the application of methylprednisolone on postoperative nausea and vomiting and pain after total knee arthroplasty.Methods 86 patients with total knee arthroplasty(TKA)were randomly assigned to two groups which were methylprednisolone group(43 cases)and control group(43 cases)during from November 2015 to June 2016 according to the strict inclusion criteria and exclusion criteria.Patients in the methylprednisolone group were given methylprednisolone(40mg)in intravenous within 24 hours during and after total knee arthroplasty(TKA).Patients in the control group were given an equal volume of saline in intravenous at the same time.The postoperative nausea and vomiting was observed and recorded in both groups divided as the0-6hours,6-24 hours,24-48 hours,48-72 h and 0-72 hours after total knee arthroplasty(TKA).Visual analogue scale(VAS)score were used in the time point of the 6h,24 h,48h and 72 h after total knee arthroplasty(TKA),and knee joint scoring system score(KSS)in 3 days after TKA were recorded.C-reactive protein and fasting blood glucose were determined.The occurrence of adverse reactions such as the infection and the poor wound healing postoperatively was recorded in 6-month follow-up in both groups.Results All the 86 cases were included,and no missing cases.There was no significant difference between the two groups in gender,age and body mass index(P>0.05).The total incidence rate of postoperative nausea and vomiting during 0-72 hours after surgery(25.6%),and incidence rates of nausea and vomiting at 6 and 24 hours(16.3%,18.6%)were significantly lower in the methylprednisolone group than the control group(P<0.05).The VAS score was significantly lower in the methylprednisolone group than the control group at24 and 48 hours after surgery(P<0.05).While the VAS score in the 6h and 72 h were no difference between the control group(P>0.05).While,KSS scores were significantly higher in the methylprednisolone group than in the control group in the 3 days after the surgery(P<0.05).C-reactive protein and fasting blood glucose were not significantly different between two groups before and after surgery(P>0.05).The surgical incision was found to heal in 6-month follow-up and no postoperative infection and poor wound healing which occurred in both groups.Conclusions The result of the Intravenous methylprednisolone therapy performed in patients undergoing total knee arthroplasty(TKA)and in the 24 h after operative had shown that the methylprednisolone could decrease the postoperative nausea and vomiting as well as the pain postoperative.Also the following up result had shown that the infection was not found during the application of the methylprenisolone.And,the used in the early stage could promote the reconditioning after the TKA.In addition,it provides a new idea for the patients with total knee arthroplasty surgery.