Ninety patients with symptomatic hip dysplasia undergoing periacetabular osteotomy were randomized to receive either a single dose of dexamethasone 24 mg preoperatively followed by placebo (n=30), two doses of dexamethasone 24 mg (preoperative and 24 hours postoperative) (n=30), or placebo at both time points (n=30). The primary outcome was cumulative morphine consumption within 48 hours after surgery. Secondary outcomes included pain intensity at rest and during activity, prolonged opioid use up to 14 days, postoperative nausea and vomiting, antiemetic use, and functional recovery (Timed Up and Go test at 24 and 48 hours). Outcomes were assessed at 24 and 48 hours and up to 14 days. Overall, the results of the study revealed no significant difference in morphine use between dexamethasone and placebo and no improvements in any secondary outcomes. These findings suggest that high-dose dexamethasone does not provide opioid-sparing or symptomatic benefit following PAO.