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Effective Pain Management After Total Hip Arthroplasty in a Sickle Cell Patient Emphasizing Dexamethasone Sodium Phosphate/Methylprednisolone Acetate Administered via a Peripheral Nerve Blockade

A Case Report

Li, Jinlei, MD, PhD*; Perese, Francisco, MD*; Rubin, Lee E., MD; Carlyle, Daniel, MD*

doi: 10.1213/XAA.0000000000000877
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Pain control after total hip arthroplasty in sickle cell patients is challenging yet essential to prevent sickle cell crises or protracted hospital stays. We present a case of effective analgesia that lasted for weeks in a young opioid-tolerant female. This was achieved by the administration of glucocorticoids with different durations of action, dexamethasone sodium phosphate/methylprednisolone acetate, via a femoral/lateral femoral cutaneous nerve block placed preoperatively. Postoperatively, the patient’s opioid demand was unchanged from her preoperative baseline. She met all the discharge requirements, including physical therapy targets, on postoperative day 2 and did not have any complications during the hospitalization.

From the Departments of *Anesthesiology

Orthopaedics & Rehabilitation, Yale University, New Haven Connecticut.

Accepted for publication July 17, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Jinlei Li, MD, PhD, Department of Anesthesiology, Yale University, 333 Cedar St, TMP 3, PO Box 208051, New Haven, CT 06520. Address e-mail to Jinlei.li@yale.edu.

© 2019 International Anesthesia Research Society
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