Dexamethasone in Total Knee and Total Hip Arthroplasty

NCT ID: NCT02760043

Last Updated: 2017-11-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

314 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-04-30

Study Completion Date

2018-10-31

Brief Summary

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This study will evaluate if the addition of dexamethasone to a local infiltration analgesia mixture will improve functional outcomes following total hip and knee arthroplasty.

Detailed Description

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The addition of dexamethasone to an local infiltration analgesia (LIA) mixture for postoperative analgesia following total knee arthroplasty (TKA) has a limited evidence base. Although there is increasing support in the literature for its use in peripheral nerve blockade, there have only been a handful of studies assessing its applicability in periarticular LIA. Moreover, the evidence from peripheral nerve blocks suggests that one of the key benefits of dexamethasone is a prolongation of nerve blockade. Additionally, dexamethasone has been shown to prolong the local analgesic effect of bupivacaine microcapsules.

With respect to total hip arthroplasty (THA), there have only been two small studies that included corticosteroids in the LIA mixture; there was analgesic benefit and better early rehabilitation outcomes when compared to placebo. However, there is limited high-quality evidence for either THA or TKA demonstrating an improvement in functional outcomes when dexamethasone is used in an LIA mixture. This study will evaluate if the addition of dexamethasone to a local infiltration analgesia mixture will improve functional outcomes following total hip and knee arthroplasty.

Conditions

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Total Knee Arthroplasty Total Hip Arthroplasty Osteoarthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Dexamethasone

LIA mixture with the addition of 8mg Dexamethasone.

Group Type EXPERIMENTAL

Dexamethasone

Intervention Type DRUG

8mg (2mL) of Dexamethasone added to standard LIA mixture

LIA Combination Mixture

Intervention Type DRUG

150mL 2% Ropivacaine, 30mg Ketorolac and 0.6mg of Epinephrine

Saline

LIA mixture with the addition of 2mL of 0.9% NaCl Saline.

Group Type SHAM_COMPARATOR

0.9% NaCl Placebo

Intervention Type OTHER

2mL of 0.9% NaCl placebo (saline) added to standard LIA mixture

LIA Combination Mixture

Intervention Type DRUG

150mL 2% Ropivacaine, 30mg Ketorolac and 0.6mg of Epinephrine

Interventions

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Dexamethasone

8mg (2mL) of Dexamethasone added to standard LIA mixture

Intervention Type DRUG

0.9% NaCl Placebo

2mL of 0.9% NaCl placebo (saline) added to standard LIA mixture

Intervention Type OTHER

LIA Combination Mixture

150mL 2% Ropivacaine, 30mg Ketorolac and 0.6mg of Epinephrine

Intervention Type DRUG

Other Intervention Names

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Baycadron Saline

Eligibility Criteria

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Inclusion Criteria

* Undergoing elective, primary, unilateral total hip or knee arthroplasty under spinal anesthesia
* ASA-PS I-III
* 18-85 years of age, inclusive
* 50-100 kg, inclusive
* BMI 18 - 40

Exclusion Criteria

* Revision hip/knee arthroplasty
* Bilateral hip/knee arthroplasty
* Inability or refusal to provide informed consent
* Any contraindication to spinal anesthesia (e.g., bleeding diathesis, infection, neuropathy)
* Allergy to local anesthesia, ketorolac or dexamethasone
* Allergy to opioids
* Chronic pain state, neuropathic pain
* Opioid dependence
* Diabetic patients will NOT be excluded except those with significant peripheral neuropathy
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Health Network, Toronto

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Toronto Western Hopspital

Toronto, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Vincent Chan, MD

Role: CONTACT

Phone: 4166035118

Email: [email protected]

Kariem El-Boghdadly, MD

Role: CONTACT

Phone: 4166035800

Email: [email protected]

References

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El-Boghdadly K, Short AJ, Gandhi R, Chan V. Addition of dexamethasone to local infiltration analgesia in elective total knee arthroplasty: double-blind, randomized control trial. Reg Anesth Pain Med. 2021 Feb;46(2):130-136. doi: 10.1136/rapm-2020-102079. Epub 2020 Nov 16.

Reference Type DERIVED
PMID: 33199379 (View on PubMed)

El-Boghdadly K, Short AJ, Gandhi R, Chan VWS. Addition of dexamethasone to local infiltration analgesia in elective total hip arthroplasty: a double-blind, randomized control trial. Reg Anesth Pain Med. 2019 Sep 27:rapm-2019-100873. doi: 10.1136/rapm-2019-100873. Online ahead of print.

Reference Type DERIVED
PMID: 31563881 (View on PubMed)

Other Identifiers

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UHN15-9898-A

Identifier Type: -

Identifier Source: org_study_id