Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Effect of pre-operative methylprednisolone on orthostatic hypotension during early mobilization after total hip arthroplasty

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Inadequate emergence after non-cardiac surgery-A prospective observational study in 1000 patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Time to onset of gastrointestinal bleeding in the SUP-ICU trial: a preplanned substudy

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Use of red blood cells in Danish intensive care units: A population-based register study

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Heterogeneity of treatment effect of stress ulcer prophylaxis in ICU patients: A secondary analysis protocol

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Pantoprazole in ICU patients at risk for gastrointestinal bleeding-1-year mortality in the SUP-ICU trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. The clinical implication of the association between hypoxaemia and postoperative troponin I: a reply

    Research output: Contribution to journalComment/debateResearchpeer-review

  2. Postoperative pain management in the era of ERAS: An overview

    Research output: Contribution to journalReviewResearchpeer-review

View graph of relations

BACKGROUND: Orthostatic hypotension (OH) and intolerance (OI) are common after total hip arthroplasty (THA) and may delay early mobilization. The pathology of OH and OI includes a dysregulated post-operative vasopressor response, by a hitherto unknown mechanism. We hypothesized that OI could be related to the inflammatory stress response which is inhibited by steroid administration. Consequently, this study evaluated the effect of a pre-operative high-dose methylprednisolone on OH and OI early after THA.

METHODS: Randomized, double-blind, placebo-controlled study in 59 patients undergoing elective unilateral THA with spinal anesthesia and a standardized multimodal analgesic regime. Patients were allocated (1 : 1) to pre-operative intravenous (IV) methylprednisolone (MP) 125 mg or isotonic saline (C). OH, OI and cardiovascular responses to sitting and standing were evaluated using a standardized mobilization protocol pre-operatively, 6, and 24 h after surgery. Systolic and diastolic arterial pressure and heart rate were measured non-invasively (Nexfin® ). The systemic inflammation was monitored by the C-reactive protein (CRP) response.

RESULTS: At 6 h post-operatively, 11 (38%) versus 11 (37%) patients had OH in group MP and group C, respectively (RR 1.02 (0.60 to 1.75; P = 1.00)), whereas OI was present in 9 (31%) versus 13 (43%) patients (RR 0.76 (0.42 to 1.36; P = 0.42)), respectively. At 24 h post-operatively, the prevalence of OH and OI did not differ between groups, though CRP levels were significantly reduced in group MP (P < 0.001).

CONCLUSION: Pre-operative administration of 125 mg methylprednisolone IV did not reduce OH or OI compared with placebo despite a reduced inflammatory response.

Original languageEnglish
JournalActa Anaesthesiologica Scandinavica
Volume62
Issue number7
Pages (from-to)882-892
Number of pages11
ISSN0001-5172
Publication statusPublished - 2018

    Research areas

  • Journal Article

ID: 53627493