Effects of Dexamethasone on Nausea, Vomiting, and Inflammatory Indexes After Total Knee Arthroplasty.

Objective: Postoperative nausea and vomiting (PONV) and abnormal inflammatory markers frequently complicate recovery following total knee arthroplasty (TKA), posing diagnostic challenges in distinguishing between transient inflammatory responses and early infections. This study aimed to evaluate the specific effects of dexamethasone (DXM) on PONV incidence and inflammatory markers after TKA.

Methods: This was a retrospective cohort study including 1853 patients who underwent unilateral TKA from January 2020 to August 2021. Patients were divided into a dexamethasone group (n = 756) and a control group (n = 1097) based on postoperative DXM use. All other perioperative management was consistent between groups. Data collected included PONV incidence, white blood cell count (WBC), C-reactive protein (CRP), and postoperative clinical outcomes. Statistical analysis included the χ² test, t test, and multivariate logistic regression to control for confounding factors.

Results: The DXM group showed significantly lower incidences of PONV and lower postoperative CRP levels. WBC counts and neutrophil percentages were transiently elevated postoperatively in the DXM group without corresponding increases in postoperative complications.

Conclusion: DXM administration after TKA reduces PONV and inflammatory markers but leads to transient leukocytosis, which is not associated with an increased incidence of complications.