Despite the availability of various analgesic regimens, patient surveys
have indicated that moderate-to-severe postoperative pain is still poorly
The use of corticosteroids for postoperative pain relief, although popular,
has yet to gain wider acceptance because of concerns over side effects, in
particular adrenal suppression, osteonecrosis, impaired wound-healing, and
concerns about efficacy. The medical literature provides evidence that should
substantially decrease these concerns with regard to low and short-dose
The results of randomized trials have shown low, short-dose corticosteroid
regimens to be safe and effective for reducing postoperative pain.
There is strong, grade-A evidence supporting the use of corticosteroids in
multimodal analgesia protocols to contribute to the postoperative recovery of
the patient by minimizing opioid doses and therefore side effects. However,
the optimal mode, dose, and timing of administration remain unclear.