Evidence map›Paper›PMID 34983775›Full record

Trial reportBMJ (Clinical research ed.)2022

Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial.

Kasper Smidt Gasbjerg, Daniel Hägi-Pedersen, Troels Haxholdt Lunn, Christina Cleveland Laursen, Majken Holmqvist, Louise Ørts Vinstrup, Mette Ammitzboell, Karina Jakobsen, Mette Skov Jensen, Marie Jøhnk Pallesen and 11 more

Registry-linked trialOpen access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03506789 (Dexamethasone Twice for Pain Treatment of Total Knee Arthroplasty - A Randomized Blinded Placebo-controlled Clinical Trial), which is not on this map. Cited by 59 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 7 pooled it
27.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03506789 phase4completednot on this map

Dexamethasone Twice for Pain Treatment of Total Knee Arthroplasty - A Randomized Blinded Placebo-controlled Clinical Trial

TypeinterventionalSponsorNaestved HospitalRan2018 to 2020Enrolled485ConditionsPostoperative PainArmsDexamethasone, Placebos
3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 7 syntheses or guidelines pooled it, 126 citations in OpenAlex.

  1. Efficacy and Safety of Electroacupuncture for Pain Alleviation in Post-Total Knee Arthroplasty Patients: A Systematic Review and Meta-Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 6 institutions in 1 country.

Kasper Smidt GasbjergDepartment of Anaesthesiology, Næstved, Slagelse and Ringsted Hospitals, Næstved, Denmark.ORCID 0000-0003-1484-483X
Daniel Hägi-PedersenDepartment of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.ORCID 0000-0001-8008-6614
Troels Haxholdt LunnDepartment of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
Christina Cleveland LaursenDepartment of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.ORCID 0000-0002-9525-0920
Majken HolmqvistCentre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark.
Louise Ørts VinstrupDepartment of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.ORCID 0000-0002-3487-8845
Mette AmmitzboellDepartment of Orthopaedic Surgery and Traumatology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
Karina JakobsenDepartment of Anaesthesiology, Næstved, Slagelse and Ringsted Hospitals, Næstved, Denmark.
Mette Skov JensenDepartment of Anaesthesiology, Næstved, Slagelse and Ringsted Hospitals, Næstved, Denmark.
Marie Jøhnk PallesenDepartment of Orthopaedic Surgery and Traumatology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
Jens BaggerDepartment of Orthopaedic Surgery and Traumatology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
Peter LindholmDepartment of Anaesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark.
Niels Anker PedersenDepartment of Anaesthesia, Gildhøj Private Hospital, Brøndby, Denmark.
Henrik Morville SchrøderDepartment of Orthopaedic Surgery, Næstved-Slagelse-Ringsted Hospitals, Næstved, Denmark.
Martin Lindberg-LarsenOrthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.ORCID 0000-0002-4483-677X
Anders Kehlet NørskovDepartment of Anaesthesiology, Nordsjællands University Hospital, Hillerød, Denmark Anders.ORCID 0000-0002-6908-7832
Kasper Højgaard ThyboCentre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark.ORCID 0000-0002-4727-3132
Stig BrorsonDepartment of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.ORCID 0000-0001-5337-758X
Søren OvergaardDepartment of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.ORCID 0000-0001-6829-4787
Janus Christian JakobsenDepartment of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.ORCID 0000-0002-3642-2120
Ole MathiesenDepartment of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.ORCID 0000-0003-4544-0619
University of Copenhagen · DKRingsted Sygehus · DKZealand University Hospital Køge · DKUniversity of Southern Denmark · DKCopenhagen University Hospital · DKOdense University Hospital · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the effects of one and two doses of intravenous dexamethasone in patients after total knee arthroplasty.

designRandomised, blinded, placebo controlled trial with follow-up at 90 days.

settingFive Danish hospitals, September 2018 to March 2020.

participants485 adult participants undergoing total knee arthroplasty.

interventionA computer generated randomised sequence stratified for site was used to allocate participants to one of three groups: DX1 (dexamethasone (24 mg)+placebo); DX2 (dexamethasone (24 mg)+dexamethasone (24 mg)); or placebo (placebo+placebo). The intervention was given preoperatively and after 24 hours. Participants, investigators, and outcome assessors were blinded. All participants received paracetamol, ibuprofen, and local infiltration analgesia.

main outcome measuresThe primary outcome was total intravenous morphine consumption 0 to 48 hours postoperatively. Multiplicity adjusted threshold for statistical significance was P<0.017 and minimal important difference was 10 mg morphine. Secondary outcomes included postoperative pain.

results485 participants were randomised: 161 to DX1, 162 to DX2, and 162 to placebo. Data from 472 participants (97.3%) were included in the primary outcome analysis. The median (interquartile range) morphine consumptions at 0-48 hours were: DX1 37.9 mg (20.7 to 56.7); DX2 35.0 mg (20.6 to 52.0); and placebo 43.0 mg (28.7 to 64.0). Hodges-Lehmann median differences between groups were: -2.7 mg (98.3% confidence interval -9.3 to 3.7), P=0.30 between DX1 and DX2; 7.8 mg (0.7 to 14.7), P=0.008 between DX1 and placebo; and 10.7 mg (4.0 to 17.3), P<0.001 between DX2 and placebo. Postoperative pain was reduced at 24 hours with one dose, and at 48 hours with two doses, of dexamethasone.

conclusionTwo doses of dexamethasone reduced morphine consumption during 48 hours after total knee arthroplasty and reduced postoperative pain.

trial registrationClinicaltrials.gov NCT03506789.

Indexed as

AcetaminophenAgedAnalgesicsArthroplasty, Replacement, KneeDexamethasoneDouble-Blind MethodDrug Therapy, CombinationFemaleHumansIbuprofenMaleMiddle AgedMorphinePain ManagementPain MeasurementPostoperative PainAcetaminophenAnalgesicsDexamethasoneIbuprofenMorphine

Identifiers

PMID34983775
PMCPMC8724786
OpenAlexW4205705357

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.