British National Formulary. Peri-operative analgesia: opioid analgesics. 2022a. (accessed 15 July 2022)

British National Formulary. Dexamethasone. 2022b. (accessed 15 July 2022)

Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial. 2022.

National Institute for Health and Care Excellence. Controlled drugs: safe use and management. 2016. (accessed 15 July 2022)

A meta-analysis of dexamethasone for pain management in patients with total knee arthroplasty. 2018.

Dexamethasone as an adjunct to pain management following knee surgery

02 August 2022
Volume 27 · Issue 8

Pain is often moderate to severe following knee arthroscopy, and the addictive nature of opioids in its management is well documented. Currently, the British National Formulary (BNF, 2022a) states that opioid analgesics can be given to patients with moderate-to-severe postoperative pain, with the dose given as soon as the patient can eat and drink. The dosage is then reduced or adjusted as soon as possible so as to aid functional recovery. Morphine, if not administered orally, can be given via patient-controlled analgesia (PCA).

The National Institute for Health and Care Excellence (NICE, 2016) recommends caution when prescribing controlled drugs such as morphine. Both the benefits and risks should be considered, such as the dangers of over-prescribing, dependency, overdose and diversion. In addition, all medications currently being taken by the patient must be carefully considered, along with the possibility that the patient might be opioid-naïve (NICE, 2016).

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