Endocrine and immune effects of dexamethasone in unilateral total knee replacement.
The effect of acute pre-surgery dexamethasone treatment on the inflammatory immune and endocrine responses to orthopaedic surgery was investigated. Whole blood samples were obtained before and 5 days after surgery for immune analysis, and serum was obtained before and 6 h, 3 days and 5 days after surgery for endocrine assessment. Dexamethasone did not affect the post-surgery granulocyte response, but inhibited the increase in monocyte count (an average increase of 38.5% was seen in the control group). Peak C-reactive protein concentration (3 days after surgery) was 51.4% lower in the dexamethasone group than in the control group. Dexamethasone had a major effect on cortisol concentrations and the cortisol:testosterone and cortisol:dehydroepiandrosterone ratios, but no effect on anabolic hormone concentrations. In conclusion, acute pre-surgery dexamethasone treatment may have beneficial effects in the post-surgery period, by limiting the extent of systemic inflammation and the cortisol response.
Smith
C
C
Department of Physiological Sciences, Stellenbosch University, Matieland, South Africa. csmith@sun.ac.za
Erasmus
P J
PJ
Myburgh
K H
KH
D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D003687:Dehydroepiandrosterone / Q000097:blood*; D003907:Dexamethasone / Q000008:administration & dosage / Q000494:pharmacology*; D006098:Granulocytes / Q000187:drug effects*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D013739:Testosterone / Q000097:blood*
D013739:Testosterone; D003687:Dehydroepiandrosterone; D003907:Dexamethasone; D006854:Hydrocortisone