| Abstract ID |
| 20260123 |
| 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 |
| Sirabhop Leupatanasuk |
| 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: To evaluate and compare the efficacy of a multiple-dose intravenous dexamethasone regimen against a standard single-dose regimen in terms of reducing postoperative pain scores and opioid consumption in patients postoperative arthroscopic anterior cruciate ligament (ACL) 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 characteristics were comparable between groups. Longitudinal analysis using a mixed-effects model revealed that the Multiple-Dose Group experienced significantly lower overall pain scores, with an average reduction of 1.0 point on the VAS compared to the Single-Dose Group (Beta = -1.0; 95% CI: -1.9 to -0.13; p = 0.025). Specifically, significant pain reduction occurred at 8 hours (mean VAS 1.57 vs. 3.38; p = 0.046) and 12 hours post-operation (mean VAS 1.57 vs. 3.44; p = 0.035). While the Multiple-Dose Group required 37% less morphine (4.11 mg vs. 6.56 mg), this was not statistically significant (p = 0.567). No significant differences were found in complication rates, including surgical site infections. Conclusion: A multiple-dose regimen of IV dexamethasone provides superior and more sustained postoperative pain control than a single preoperative dose for patients undergoing arthroscopic double-bundle ACL reconstruction. This regimen effectively mitigates rebound pain and serves as a valuable component of multimodal analgesia. |