Shoulder Arthroscopy, Pain
Conditions
Brief summary
Previous studies have confirmed that IV dexamethasone prolongs brachial plexus blocks. However, these studies only used fixed doses of IV dexamethasone at relatively high doses, which could potentially lead to increased glucose levels, delayed wound healing, and unintended side effects. There remains a paucity of research on the effective dose range of IV dexamethasone for the prolongation of supraclavicular blocks. The optimal dosage of IV dexamethasone for prolongation of analgesia vs. motor block prolongation from supraclavicular blocks in shoulder surgery has yet to be delineated.
Detailed description
Numerous studies have confirmed that perineural dexamethasone prolongs bupivacaine and ropivacaine brachial plexus blocks by approximately 10 hours (from approx. 12 to 22 hours) without clinical evidence of toxicity. However, perineural toxicity in an animal model has raised concern about its use as a peripheral nerve block adjuvant. Moreover, recent studies suggest that high dose IV dexamethasone (810mg) prolongs analgesia to a similar degree as perineural dexamethasone for interscalene, supraclavicular and sciatic nerve blocks performed with ropivacaine and bupivacaine. However these studies only utilized fixed, high level doses of IV dexamethasone. Moreover, there remains a concern that high dose IV dexamethasone may lead to postoperative hyperglycemia and could possibly increase the risk of postoperative wound infection. Open surgery under general anesthesia has been shown to increase blood glucose levels with a peak at approximately 2 hours post-induction and results have been conflicting regarding whether or not IV dexamethasone causes greater increase. To the investigators' knowledge, it is not yet known if arthroscopic surgery under regional anesthesia triggers a similar increase in blood glucose levels and if this is impacted by administration of IV dexamethasone. The investigators aim to identify the duration of supraclavicular block prolongation that can be expected over a range of doses of IV dexamethasone. The investigators also seek to identify what association, if any, is noted between IV dexamethasone and changes in blood glucose levels after shoulder surgery with regional anesthesia and sedation. Finally, the investigators will collect data on side effects and postoperative complications, if any, in patients receiving a range of doses of IV dexamethasone.
Interventions
Sponsors
Hospital for Special Surgery, New York
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
\- Patients undergoing shoulder arthroscopy under regional anesthesia
Exclusion criteria
* General anesthesia * Contraindication to regional anesthesia * Pre-existing neuropathy in the surgical limb * Diabetes Mellitus * History of postoperative nausea and vomiting &/ or motion sickness * Procedures involving biceps tenotomy * Peri-articular cocktail injections given intraoperatively to augment pain relief * Chronic pain (daily opioid and/or gabapentinoid use for 6 weeks) * Open surgical procedures * Corticosteroid injection within 1 month * Patients on systemic oral or IV steroid therapy within 6 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Analgesia From a Supraclavicular Block Performed for Shoulder Arthroscopy | Day of Surgery until Post-Operative Day 3 (if the block persists) | Defined as time from block placement until pain relief from the block completely wears off in the operative shoulder. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Motor Block From the Supraclavicular Block | Day of Surgery until Post-Operative Day 3 (if the block persists) | Defined as the time from block placement to restoration of normal strength at both the wrist and elbow. |
| Blood Glucose Levels | Day of Surgery - before and 1-hour and 2-hours after IV Dexamethasone administration | Fingerstick blood glucose test to be administered before and 1-hour and 2-hours after IV dexamethasone administration. |
| Occurrence of Postoperative Neuropraxia | Post-Operative Day 21 | Documentation of any of these occurrences will be obtained from the surgeons and/or medical charts after the postoperative follow up visit. |
| Occurrence of Postoperative Wound Infection | Post-Operative Day 21 | Documentation of any of these occurrences will be obtained from the surgeons and/or medical charts after the postoperative follow up visit. |
| Average Daily Pain Scores at Rest and With Movement | Day of Surgery until Post-Operative Day 3 (if the block persists) | Using the Numeric Rating Scale (NRS) Pain obtained by patient interview. Lower numbers represent less pain and better outcomes. The scale range is from 0 (no pain) to 10 (worst pain possible). |
| Worst Daily Pain Scores at Rest and With Movement | Day of Surgery until Post-Operative Day 3 (if the block persists) | Using the numeric pain rating scale (NRS), will be obtained by patient interview. Lower numbers represent less pain and better outcomes. The scale range is from 0 (no pain) to 10 (worst pain possible). |
| Patient Satisfaction With Postoperative Analgesia | Post-Operative Day 2 or Post-Operative Day 3 (if the block persists) | Patient satisfaction with postoperative analgesia will be obtained by patient interview. Lower numbers represent worse outcomes. The scale range is from 0 (worst) to 10 (best). |
| Cumulative Daily Opioid Usage | Recovery Room until Post-Operative Day 3 (if block persists) | Dosages (reported in Morphine equivalent units) of opioid medication obtained by medical records and/or by patient interview. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| 0mg IV Dexamethasone 0mg IV Dexamethasone | 35 |
| 4mg IV Dexamethasone 4mg IV Dexamethasone | 34 |
| 6mg IV Dexamethasone 6mg IV Dexamethasone | 33 |
| 8mg IV Dexamethasone 8mg IV Dexamethasone | 35 |
| Total | 137 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Overall Study | Lost to Follow-up | 0 | 0 | 2 | 0 |
| Overall Study | Withdrawal by Subject | 0 | 1 | 0 | 0 |
Baseline characteristics
| Characteristic | 0mg IV Dexamethasone | 4mg IV Dexamethasone | 6mg IV Dexamethasone | 8mg IV Dexamethasone | Total |
|---|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 7 Participants | 7 Participants | 8 Participants | 3 Participants | 25 Participants |
| Age, Categorical Between 18 and 65 years | 28 Participants | 27 Participants | 25 Participants | 32 Participants | 112 Participants |
| Age, Continuous | 49 years STANDARD_DEVIATION 16 | 50 years STANDARD_DEVIATION 17 | 52 years STANDARD_DEVIATION 15 | 49 years STANDARD_DEVIATION 12 | 50 years STANDARD_DEVIATION 15 |
| Race/Ethnicity, Customized Race Asian | 1 Participants | 0 Participants | 0 Participants | 1 Participants | 2 Participants |
| Race/Ethnicity, Customized Race Black/African American | 1 Participants | 1 Participants | 1 Participants | 0 Participants | 3 Participants |
| Race/Ethnicity, Customized Race Unknown | 0 Participants | 1 Participants | 0 Participants | 2 Participants | 3 Participants |
| Race/Ethnicity, Customized Race White | 33 Participants | 32 Participants | 32 Participants | 32 Participants | 129 Participants |
| Region of Enrollment United States | 35 participants | 34 participants | 33 participants | 35 participants | 137 participants |
| Sex: Female, Male Female | 16 Participants | 6 Participants | 10 Participants | 10 Participants | 42 Participants |
| Sex: Female, Male Male | 19 Participants | 28 Participants | 23 Participants | 25 Participants | 95 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 35 | 0 / 34 | 0 / 33 | 0 / 35 |
| other Total, other adverse events | 4 / 35 | 2 / 34 | 6 / 33 | 3 / 35 |
| serious Total, serious adverse events | 0 / 35 | 0 / 34 | 0 / 33 | 0 / 35 |
Outcome results
Primary
Duration of Analgesia From a Supraclavicular Block Performed for Shoulder Arthroscopy
Defined as time from block placement until pain relief from the block completely wears off in the operative shoulder.
Time frame: Day of Surgery until Post-Operative Day 3 (if the block persists)
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| 0mg IV Dexamethasone | Duration of Analgesia From a Supraclavicular Block Performed for Shoulder Arthroscopy | 17.4 Hours |
| 4mg IV Dexamethasone | Duration of Analgesia From a Supraclavicular Block Performed for Shoulder Arthroscopy | 22.7 Hours |
| 6mg IV Dexamethasone | Duration of Analgesia From a Supraclavicular Block Performed for Shoulder Arthroscopy | 20.2 Hours |
| 8mg IV Dexamethasone | Duration of Analgesia From a Supraclavicular Block Performed for Shoulder Arthroscopy | 19.8 Hours |
Secondary
Average Daily Pain Scores at Rest and With Movement
Using the Numeric Rating Scale (NRS) Pain obtained by patient interview. Lower numbers represent less pain and better outcomes. The scale range is from 0 (no pain) to 10 (worst pain possible).
Time frame: Day of Surgery until Post-Operative Day 3 (if the block persists)
Population: Average daily pain scores Pre-Op to POD3 at rest and with movement.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | Pre-Op Average Pain Score at rest | 2.6 score on a scale | Standard Deviation 1.9 |
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD0 Average Pain Score at rest | 0.4 score on a scale | Standard Deviation 1.1 |
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD1 Average Pain Score at rest | 4.1 score on a scale | Standard Deviation 2.5 |
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD2 Average Pain Score at rest | 2.9 score on a scale | Standard Deviation 2.1 |
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD3 Average Pain Score at rest | 0.5 score on a scale | Standard Deviation 0.7 |
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | Pre-Op Average Pain Score with Movement | 4.6 score on a scale | Standard Deviation 2.3 |
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD0 Average Pain Score with Movement | 0.5 score on a scale | Standard Deviation 1.4 |
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD1 Average Pain Score with Movement | 5.2 score on a scale | Standard Deviation 2.6 |
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD2 Average Pain Score with Movement | 4.6 score on a scale | Standard Deviation 2.6 |
| 0mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD3 Average Pain Score with Movement | 6 score on a scale | Standard Deviation 2.8 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD1 Average Pain Score at rest | 3.2 score on a scale | Standard Deviation 2.1 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD2 Average Pain Score with Movement | 5.1 score on a scale | Standard Deviation 2.3 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD2 Average Pain Score at rest | 3.7 score on a scale | Standard Deviation 1.8 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD3 Average Pain Score at rest | 4 score on a scale | Standard Deviation 1.7 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | Pre-Op Average Pain Score with Movement | 4.8 score on a scale | Standard Deviation 2.3 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD0 Average Pain Score with Movement | 0.3 score on a scale | Standard Deviation 0.8 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD3 Average Pain Score with Movement | 5 score on a scale | Standard Deviation 3 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD1 Average Pain Score with Movement | 4.7 score on a scale | Standard Deviation 2.2 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | Pre-Op Average Pain Score at rest | 3 score on a scale | Standard Deviation 2.5 |
| 4mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD0 Average Pain Score at rest | 0.2 score on a scale | Standard Deviation 0.7 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD1 Average Pain Score with Movement | 4.8 score on a scale | Standard Deviation 3.1 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD0 Average Pain Score with Movement | 0.2 score on a scale | Standard Deviation 0.5 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD3 Average Pain Score with Movement | 6 score on a scale | Standard Deviation 0 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | Pre-Op Average Pain Score at rest | 2.4 score on a scale | Standard Deviation 2.4 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD2 Average Pain Score at rest | 3.3 score on a scale | Standard Deviation 2.7 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | Pre-Op Average Pain Score with Movement | 4.6 score on a scale | Standard Deviation 2.4 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD2 Average Pain Score with Movement | 5 score on a scale | Standard Deviation 2.3 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD0 Average Pain Score at rest | 0.4 score on a scale | Standard Deviation 0.9 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD3 Average Pain Score at rest | 3 score on a scale | Standard Deviation 0 |
| 6mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD1 Average Pain Score at rest | 3.1 score on a scale | Standard Deviation 2.8 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD3 Average Pain Score at rest | 2 score on a scale | Standard Deviation 2 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD1 Average Pain Score with Movement | 4.2 score on a scale | Standard Deviation 3.3 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | Pre-Op Average Pain Score with Movement | 4.7 score on a scale | Standard Deviation 2.7 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD3 Average Pain Score with Movement | 1.7 score on a scale | Standard Deviation 1.5 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD0 Average Pain Score with Movement | 0.4 score on a scale | Standard Deviation 1.7 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD0 Average Pain Score at rest | 0.5 score on a scale | Standard Deviation 1.6 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD1 Average Pain Score at rest | 3 score on a scale | Standard Deviation 2.5 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD2 Average Pain Score at rest | 3.1 score on a scale | Standard Deviation 2.4 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | Pre-Op Average Pain Score at rest | 2.5 score on a scale | Standard Deviation 2.5 |
| 8mg IV Dexamethasone | Average Daily Pain Scores at Rest and With Movement | POD2 Average Pain Score with Movement | 4.8 score on a scale | Standard Deviation 2.3 |
Secondary
Blood Glucose Levels
Fingerstick blood glucose test to be administered before and 1-hour and 2-hours after IV dexamethasone administration.
Time frame: Day of Surgery - before and 1-hour and 2-hours after IV Dexamethasone administration
Population: Prior to IV Dexamethasone, 1-hour and 2-hours after IV Dexamethasone administration
| Arm | Measure | Group | Value (MEDIAN) | Dispersion |
|---|---|---|---|---|
| 0mg IV Dexamethasone | Blood Glucose Levels | Prior to IV Dexamethasone | 102 mg/dL | Standard Deviation 15 |
| 0mg IV Dexamethasone | Blood Glucose Levels | 2 hours after IV Dexamethasone | 102 mg/dL | Standard Deviation 20 |
| 0mg IV Dexamethasone | Blood Glucose Levels | 1 hour after IV Dexamethasone | 119 mg/dL | Standard Deviation 14 |
| 4mg IV Dexamethasone | Blood Glucose Levels | Prior to IV Dexamethasone | 108 mg/dL | Standard Deviation 14 |
| 4mg IV Dexamethasone | Blood Glucose Levels | 2 hours after IV Dexamethasone | 125 mg/dL | Standard Deviation 31 |
| 4mg IV Dexamethasone | Blood Glucose Levels | 1 hour after IV Dexamethasone | 122 mg/dL | Standard Deviation 17 |
| 6mg IV Dexamethasone | Blood Glucose Levels | 1 hour after IV Dexamethasone | 119 mg/dL | Standard Deviation 18 |
| 6mg IV Dexamethasone | Blood Glucose Levels | Prior to IV Dexamethasone | 104 mg/dL | Standard Deviation 16 |
| 6mg IV Dexamethasone | Blood Glucose Levels | 2 hours after IV Dexamethasone | 110 mg/dL | Standard Deviation 23 |
| 8mg IV Dexamethasone | Blood Glucose Levels | Prior to IV Dexamethasone | 105 mg/dL | Standard Deviation 18 |
| 8mg IV Dexamethasone | Blood Glucose Levels | 2 hours after IV Dexamethasone | 110 mg/dL | Standard Deviation 27 |
| 8mg IV Dexamethasone | Blood Glucose Levels | 1 hour after IV Dexamethasone | 126 mg/dL | Standard Deviation 18 |
Secondary
Cumulative Daily Opioid Usage
Dosages (reported in Morphine equivalent units) of opioid medication obtained by medical records and/or by patient interview.
Time frame: Recovery Room until Post-Operative Day 3 (if block persists)
Population: Cumulative Daily Opioid Usage
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 0mg IV Dexamethasone | Cumulative Daily Opioid Usage | POD 1 (0-24hrs) | 31 oral morphine equivalent units (mg) | Standard Deviation 23.7 |
| 0mg IV Dexamethasone | Cumulative Daily Opioid Usage | POD2 (24-48hrs) | 22.3 oral morphine equivalent units (mg) | Standard Deviation 28.2 |
| 4mg IV Dexamethasone | Cumulative Daily Opioid Usage | POD2 (24-48hrs) | 27.4 oral morphine equivalent units (mg) | Standard Deviation 41.4 |
| 4mg IV Dexamethasone | Cumulative Daily Opioid Usage | POD 1 (0-24hrs) | 30.5 oral morphine equivalent units (mg) | Standard Deviation 29.3 |
| 6mg IV Dexamethasone | Cumulative Daily Opioid Usage | POD 1 (0-24hrs) | 30.7 oral morphine equivalent units (mg) | Standard Deviation 25.9 |
| 6mg IV Dexamethasone | Cumulative Daily Opioid Usage | POD2 (24-48hrs) | 32.6 oral morphine equivalent units (mg) | Standard Deviation 29.3 |
| 8mg IV Dexamethasone | Cumulative Daily Opioid Usage | POD 1 (0-24hrs) | 31.3 oral morphine equivalent units (mg) | Standard Deviation 34.1 |
| 8mg IV Dexamethasone | Cumulative Daily Opioid Usage | POD2 (24-48hrs) | 36.5 oral morphine equivalent units (mg) | Standard Deviation 47.5 |
Secondary
Duration of Motor Block From the Supraclavicular Block
Defined as the time from block placement to restoration of normal strength at both the wrist and elbow.
Time frame: Day of Surgery until Post-Operative Day 3 (if the block persists)
Population: shoulder arthroscopy
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| 0mg IV Dexamethasone | Duration of Motor Block From the Supraclavicular Block | 10.5 Hours |
| 4mg IV Dexamethasone | Duration of Motor Block From the Supraclavicular Block | 19.7 Hours |
| 6mg IV Dexamethasone | Duration of Motor Block From the Supraclavicular Block | 18.3 Hours |
| 8mg IV Dexamethasone | Duration of Motor Block From the Supraclavicular Block | 14.7 Hours |
Secondary
Occurrence of Postoperative Neuropraxia
Documentation of any of these occurrences will be obtained from the surgeons and/or medical charts after the postoperative follow up visit.
Time frame: Post-Operative Day 21
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| 0mg IV Dexamethasone | Occurrence of Postoperative Neuropraxia | 0 Participants |
| 4mg IV Dexamethasone | Occurrence of Postoperative Neuropraxia | 1 Participants |
| 6mg IV Dexamethasone | Occurrence of Postoperative Neuropraxia | 0 Participants |
| 8mg IV Dexamethasone | Occurrence of Postoperative Neuropraxia | 0 Participants |
Secondary
Occurrence of Postoperative Wound Infection
Documentation of any of these occurrences will be obtained from the surgeons and/or medical charts after the postoperative follow up visit.
Time frame: Post-Operative Day 21
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| 0mg IV Dexamethasone | Occurrence of Postoperative Wound Infection | 0 Participants |
| 4mg IV Dexamethasone | Occurrence of Postoperative Wound Infection | 0 Participants |
| 6mg IV Dexamethasone | Occurrence of Postoperative Wound Infection | 0 Participants |
| 8mg IV Dexamethasone | Occurrence of Postoperative Wound Infection | 0 Participants |
Secondary
Patient Satisfaction With Postoperative Analgesia
Patient satisfaction with postoperative analgesia will be obtained by patient interview. Lower numbers represent worse outcomes. The scale range is from 0 (worst) to 10 (best).
Time frame: Post-Operative Day 2 or Post-Operative Day 3 (if the block persists)
Population: Patient Satisfaction with Post-Op Analgesia
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| 0mg IV Dexamethasone | Patient Satisfaction With Postoperative Analgesia | 9.1 score on a scale | Standard Deviation 1.2 |
| 4mg IV Dexamethasone | Patient Satisfaction With Postoperative Analgesia | 8.9 score on a scale | Standard Deviation 1.6 |
| 6mg IV Dexamethasone | Patient Satisfaction With Postoperative Analgesia | 9.2 score on a scale | Standard Deviation 1.2 |
| 8mg IV Dexamethasone | Patient Satisfaction With Postoperative Analgesia | 8.7 score on a scale | Standard Deviation 1.7 |
Secondary
Worst Daily Pain Scores at Rest and With Movement
Using the numeric pain rating scale (NRS), will be obtained by patient interview. Lower numbers represent less pain and better outcomes. The scale range is from 0 (no pain) to 10 (worst pain possible).
Time frame: Day of Surgery until Post-Operative Day 3 (if the block persists)
Population: Worst Daily Pain Scores at rest and with movement from Pre-Op to POD3
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD0 Worst Pain Score with Movement | 0.6 score on a scale | Standard Deviation 1.9 |
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD3 Worst Pain Score at rest | 2 score on a scale | Standard Deviation 1.4 |
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD1 Worst Pain Score at rest | 6.3 score on a scale | Standard Deviation 2.9 |
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | Pre-Op Worst Pain Score with Movement | 6.1 score on a scale | Standard Deviation 2.7 |
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD0 Worst Pain Score at rest | 0.6 score on a scale | Standard Deviation 1.5 |
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD3 Worst Pain Score with Movement | 7 score on a scale | Standard Deviation 1.4 |
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD2 Worst Pain Score with Movement | 6.5 score on a scale | Standard Deviation 2.9 |
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD2 Worst Pain Score at rest | 4.7 score on a scale | Standard Deviation 3 |
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | Pre-Op Worst Pain Score at rest | 3.4 score on a scale | Standard Deviation 2.1 |
| 0mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD1 Worst Pain Score with Movement | 7.3 score on a scale | Standard Deviation 2.6 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD0 Worst Pain Score with Movement | 0.3 score on a scale | Standard Deviation 0.8 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD1 Worst Pain Score at rest | 4.6 score on a scale | Standard Deviation 2.8 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD2 Worst Pain Score at rest | 5.4 score on a scale | Standard Deviation 2.3 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD3 Worst Pain Score at rest | 6.3 score on a scale | Standard Deviation 2.9 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | Pre-Op Worst Pain Score with Movement | 6.5 score on a scale | Standard Deviation 2.4 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD0 Worst Pain Score at rest | 0.2 score on a scale | Standard Deviation 0.7 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD1 Worst Pain Score with Movement | 5.9 score on a scale | Standard Deviation 2.7 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD2 Worst Pain Score with Movement | 6.8 score on a scale | Standard Deviation 2.2 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD3 Worst Pain Score with Movement | 6.7 score on a scale | Standard Deviation 3.2 |
| 4mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | Pre-Op Worst Pain Score at rest | 3.3 score on a scale | Standard Deviation 2.9 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD0 Worst Pain Score at rest | 0.5 score on a scale | Standard Deviation 1.3 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD1 Worst Pain Score at rest | 5.4 score on a scale | Standard Deviation 3.2 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD1 Worst Pain Score with Movement | 6.5 score on a scale | Standard Deviation 3.1 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD3 Worst Pain Score with Movement | 7 score on a scale | Standard Deviation 0 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD0 Worst Pain Score with Movement | 0.3 score on a scale | Standard Deviation 0.8 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD3 Worst Pain Score at rest | 5 score on a scale | Standard Deviation 0 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD2 Worst Pain Score at rest | 5.1 score on a scale | Standard Deviation 2.8 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | Pre-Op Worst Pain Score with Movement | 6.4 score on a scale | Standard Deviation 2.5 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | Pre-Op Worst Pain Score at rest | 3.4 score on a scale | Standard Deviation 2.6 |
| 6mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD2 Worst Pain Score with Movement | 6.7 score on a scale | Standard Deviation 2.2 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD2 Worst Pain Score at rest | 4.5 score on a scale | Standard Deviation 3.3 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD0 Worst Pain Score with Movement | 1.2 score on a scale | Standard Deviation 3.3 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD1 Worst Pain Score with Movement | 5.7 score on a scale | Standard Deviation 3.4 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD1 Worst Pain Score at rest | 5.1 score on a scale | Standard Deviation 3.5 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD2 Worst Pain Score with Movement | 6.3 score on a scale | Standard Deviation 2.5 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | Pre-Op Worst Pain Score at rest | 3.6 score on a scale | Standard Deviation 3.1 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD3 Worst Pain Score at rest | 4.3 score on a scale | Standard Deviation 3.5 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD3 Worst Pain Score with Movement | 3.7 score on a scale | Standard Deviation 3.2 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | Pre-Op Worst Pain Score with Movement | 6.9 score on a scale | Standard Deviation 2.7 |
| 8mg IV Dexamethasone | Worst Daily Pain Scores at Rest and With Movement | POD0 Worst Pain Score at rest | 1.1 score on a scale | Standard Deviation 2.7 |