| Abstract ID |
| 20260121 |
| Category |
| Knee: ACL |
| Preferable Presentation |
| Poster |
| Title |
| EFFICACY OF MULTIPLE-DOSE VERSUS SINGLE-DOSE INTRAVENOUS DEXAMETHASONE FOR POSTOPERATIVE PAIN CONTROL IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A RETROSPECTIVE COHORT STUDY |
| Author |
|
| Presenter |
| สิรภพ ลือพัฒนสุข |
| Abstract |
| Background: Postoperative pain management after arthroscopic anterior cruciate ligament (ACL) reconstruction is crucial for early rehabilitation. While single-dose dexamethasone is commonly used as an adjuvant, its duration of action may not cover the rebound pain period after spinal anesthesia wears off. This study aims to evaluate the efficacy of multiple-dose intravenous dexamethasone compared to a single dose in reducing postoperative pain and opioid consumption. Objectives: Evaluate and compare the efficacy of a multiple-dose intravenous dexamethasone regimen against a standard single-dose regimen for reducing postoperative pain scores and opioid consumption in patients after arthroscopic double bundle anterior cruciate ligament reconstruction. Methods: A retrospective cohort study was conducted on 43 patients who underwent arthroscopic double bundle ACL reconstruction using hamstring autografts under spinal anesthesia between January 2024 and November 2025. Patients were divided into two groups: the Single-Dose Group (n=16) received 8 mg of IV dexamethasone preoperatively, while the Multiple-Dose Group (n=27) received 8 mg preoperatively followed by 8 mg every 8 hours total of 3 doses. The primary outcome was the Visual Analog Scale (VAS) pain score at 2, 4, 6, 8, 12, 18, 24, 36, and 48 hours. Secondary outcomes included total morphine consumption, time to first rescue analgesic, and complications Results: Baseline demographic characteristics were generally comparable between the two cohorts, though a significantly higher proportion of patients in the Single-Dose group were active smokers (31.2% vs. 3.7%, p = 0.021). Longitudinal analysis using a mixed-effects model demonstrated a statistically significant reduction in overall pain scores for the Multiple-Dose group. Specifically, statistically significant differences in pain were observed at 8 hours (mean VAS 1.57 for multiple-dose vs. 3.38 for single-dose; p = 0.046) and at 12 hours post-op (mean VAS 1.57 vs. 3.44; p = 0.035). Assignment to the multiple-dose regimen was associated with a 1.0-point average reduction in VAS scores across the 48-hour period compared to the single-dose regimen (Beta = -1.0; 95% CI: -1.9 to -0.13; p = 0.025). Time was also a significant predictor of pain progression (Beta = 0.16; p = 0.003). Conclusion: A multiple-dose regimen of intravenous dexamethasone provides significantly superior and more sustained postoperative pain control compared to a single preoperative dose in patients undergoing arthroscopic double bundle ACL reconstruction. |