To investigate the clinical efficacy and safety of using twice low-dose dexamethasone in the treatment of pain and rehabilitation following total hip arthroplasty (THA).

From October 2017 to October 2018, patients in the Orthopedics Center of the Third People’s Hospital of Huizhou who needed primary THA were selected. The patients with dexamethasone allergy, alcohol or drug abuse, rheumatic immune system diseases, and the patients who were given any strong opioids or other cardiopulmonary defects 7d before surgery were excluded. A total of 80 THA patients were divided into control group and experimental group by random number table method. The control group received 10 mg dexamethasone intravenously before anesthesia induction and the experimental group received two doses of 10 mg dexamethasone before and 12 h after anesthesia induction. C-reactive protein (CRP), interleukin-6 (IL-6) levels and visual analogue scale (VAS), postoperative incidence of nausea and vomiting (PONV), postoperative fatigue, hip range of motion (ROM), length of stay, analgesics and antiemetic consumption and complications were compared by t test or chi-square test.

The level of CRP in the experimental group was lower than that in the control group in 24 h (t =-1.259, P<0.05), 48h (t=-2.684, P<0.05)and 72 h (t=-3.669, P<0.05)postoperatively. The level of IL-6 in the experimental group was lower than that in the control group in 24 h (t=-1.954, P<0.05), 48h (t=-3.418, P<0.05)and 72 h (t =-4.985, P<0.05)postoperatively. VAS of the experimental group was lower than that of the control group at 24h (t =-2.647, P<0.05), 48 h (t=-2.12, P<0.05)and 72 h (t=-1.367, P<0.05)postoperatively. Compared with the control group, the incidence of PONV was lower(χ² =1.067, P<0.01), postoperative fatigue was alleviated(t=-2.154, P<0.01), and the consumption of analgesics and antiemetic drugs was less in the experimental group than in the control group. Compared with the control group, the experimental group shortened the length of stay(t=0.517, P<0.01) and increased the ROM(t=-3.228, P<0.01). There was no early operative incision infection or gastrointestinal bleeding in both groups.

Two doses of dexamethasone in patients with THA can decrease the level of CRP, IL-6, increase the analgesic effect, and reduce the incidence of PONV and postoperative fatigue, which would not increase the risk of early surgical incision infection and gastrointestinal bleeding.