Park, Hyung Jun Chang, Moon Jong Kim, Tae Jung Kim, Tae Woo Choi, Man Ho Moon, Min Kyong Kang, Seung-Baik 2025-06-05T00:30:34Z 2025-06-05T00:30:34Z 2025-06-04 2025-05 0021-9355 https://pubs.kist.re.kr/handle/201004/152554 Background:Effective perioperative blood glucose control is crucial for reducing postoperative complications in patients with diabetes mellitus (DM) who are undergoing total knee arthroplasty (TKA). The aim of this study was to assess the impact of intravenous (IV) dexamethasone on blood glucose levels, insulin requirements, postoperative pain, and postoperative nausea and vomiting (PONV) in patients with well-controlled type-2 DM.Methods:A total of 83 Asian patients with well-controlled type-2 DM (defined as a preoperative glycated hemoglobin level of <= 7.0%) undergoing primary TKA were randomized to receive either IV dexamethasone or normal saline solution. Blood glucose and insulin requirements were monitored postoperatively up to day 5, and pain and PONV were assessed using a numeric rating scale.Results:Compared with the control, IV dexamethasone transiently elevated blood glucose levels on the day of surgery and on postoperative day 1, with the levels returning to baseline by day 3. Insulin requirements were higher in the intervention group on postoperative day 1 (p = 0.004). While IV dexamethasone did not significantly reduce PONV, it effectively alleviated postoperative pain up to day 3.Conclusions:In patients with DM who underwent TKA, IV dexamethasone administration transiently increased blood glucose on the day of surgery and on postoperative day 1 and elevated insulin requirements on postoperative day 1. Despite having no impact on PONV, IV dexamethasone provided clinical benefits by reducing early postoperative pain. These findings suggest the potential benefits of IV dexamethasone in enhancing perioperative management strategies for patients with DM who are undergoing TKA.Level of Evidence:Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. English Journal of Bone and Joint Surgery Intravenous Dexamethasone Transiently Elevates Blood Glucose Levels and Reduces Pain After TKA in Patients with Type-2 Diabetes Mellitus Article 10.2106/JBJS.24.00984 1 The Journal of Bone & Joint Surgery, v.107, no.10, pp.1073 - 1081 The Journal of Bone & Joint Surgery 107 10 1073 1081 N scie scopus 001492084700002 2-s2.0-105002621041 Orthopedics Surgery Orthopedics Surgery Article TOTAL JOINT ARTHROPLASTY TOTAL KNEE ARTHROPLASTY POSTOPERATIVE PAIN SYSTEMIC DEXAMETHASONE GLYCEMIC CONTROL HEMOGLOBIN A1C SURGERY EMESIS NAUSEA HBA1C