Impact of Dexamethasone on Length of Stay and Early Pain Control in Direct Anterior Approach Total Hip Arthroplasty with Neuraxial Anesthesia

Abstract Introduction Dexamethasone has been shown to reduce postoperative pain and opioid consumption for total joint arthroplasty patients, however its impact on patients who received neuraxial anesthesia (NA) is not well described. We examined the impact of perioperative dexamethasone on outcomes for patients undergoing direct anterior approach total hip arthroplasty (THA) under NA. Methods Retrospective review was conducted for 376 THA patients from a single institution. Univariate analysis was used to compare postoperative outcomes for 164 THA patients receiving dexamethasone compared to 212 who did not receive dexamethasone. Results No differences in age, gender, body mass index or American Society of Anesthesiologists (ASA) Score were observed between the groups. Patients receiving perioperative dexamethasone reported statistically significantly lower post-anesthesia care unit (PACU) pain numeric rating scale (Dexamethasone 1.6 vs No Dexamethasone 2.3, P =0.014) and received lower PACU morphine milligram equivalents (MME) (Dexamethasone 8.57 vs No Dexamethasone 11.44, P  Conclusion Perioperative dexamethasone is associated with decreased postoperative pain and narcotic consumption, and shorter length of stay for patients undergoing primary direct anterior approach THA with NA.