# Effect of high-dose dexamethasone on morphine use after periacetabular osteotomy for hip dysplasia: a randomized double-blind placebo-controlled single center trial

## TL;DR

This study found that high-dose dexamethasone did not reduce morphine use or improve recovery after a hip surgery called periacetabular osteotomy.

## Contribution

The study is the first to investigate high-dose dexamethasone's effect on opioid consumption and recovery outcomes after periacetabular osteotomy.

## Key findings

- High-dose dexamethasone did not reduce postoperative morphine consumption within 48 hours.
- No significant differences were found in secondary outcomes like pain, nausea, or mobility between groups.
- The study showed no benefit of dexamethasone on opioid use or recovery after periacetabular osteotomy.

## Abstract

Periacetabular osteotomy (PAO) for hip dysplasia is associated with intensive pain and high opioid consumption. High doses of dexamethasone may reduce this. We aimed to compare the effect of 1 or 2 doses of dexamethasone 24 mg, relative to placebo, on postoperative morphine consumption after PAO.

A 3-group, randomized, double-blind, placebo-controlled trial was undertaken on patients ≥ 18 years, undergoing PAO (ClinicalTrials.gov: NCT03874936). Randomization Group A received 1 preoperative dose of dexamethasone 24 mg and placebo 24 hours later; Group B received 1 dose of intravenous dexamethasone 24 mg preoperatively and a repeated dose 24 hours postoperatively; and Group C received placebo at both time points. The primary endpoint was the difference in least squares mean cumulative postoperative morphine consumption between the combined dexamethasone groups and placebo within 48 hours from baseline. Key secondary outcomes included postoperative pain intensity, nausea and vomiting, antiemetic consumption and Timed Up and Go at 24 and 48 hours postoperatively, and cumulative morphine consumption from 48 hours to day 14 post-operation.

90 patients were randomized to dexamethasone groups (n = 60) and placebo (n = 30); 58 and 28, respectively, completed the trial. Mean age was 31 years and 71 (79%) were females. In the combined dexamethasone group the mean cumulated postoperative morphine consumption within 48 hours was 92 mg vs 95 mg in the placebo group, corresponding to a between-group difference of –3 mg (95% confidence interval –27 to 21; P = 0.8). There were no differences observed between groups for any of the secondary outcomes.

High-dose dexamethasone did not reduce postoperative morphine use or improve any of the secondary outcomes after PAO.