A randomized clinical trial of the effects of submucosal dexamethasone after surgery for mandibular fractures.

Abstract

PURPOSE:

To evaluate the effects of immediate postoperative submucosal dexamethasone administration on postoperative pain, edema, trismus, and mandibular functions after open reduction and internal fixation (ORIF) for mandibular fractures.

PATIENTS AND METHODS:

We conducted a prospective, randomized, controlled, double-blind study of 40 patients who required ORIF for mandibular fractures under general anesthesia. The patients were divided into 2 groups, an experimental group (n = 20) who received immediate postoperative submucosal 8 mg of dexamethasone through the surgical incision site, and a control group (n = 20) who did not receive dexamethasone. Pain was assessed using a visual analog scale (VAS) score and the frequency of analgesic consumption at the various postoperative intervals. The maximum interincisal distance and facial measurements were compared before surgery and at 24, 48, and 72 hours and 7 days after surgery. The difficulty in mandibular function after surgery was graded as mild, moderate, or severe.

RESULTS:

The analgesic drugs required 2 hours after surgery and the VAS score 72 hours after surgery were significantly less (P < .05) in the experimental group than in the control group. The total number of diclofenac tablets required by the experimental group was less than that for the control group, but the difference was not statistically significant. The control group had significantly increased swelling (P < .05) compared with the experimental group from preoperatively to 24 hours postoperatively (experimental group 0.115 ± 0.143, control group 0.253 ± 0.173). No statistically significant difference was present in the mouth opening or difficulty in mandibular function at the different follow-up intervals between the 2 groups (P > .05).

CONCLUSION:

The results of our study suggest that submucosal administration of dexamethasone after ORIF for mandibular fractures is effective in reducing postoperative pain and edema.

• Authors: Ashok Dongol, Mehul Rajesh Jaisani, Leeza Pradhan, Sanad Dulal, Alok Sagtani
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 73 Issue 6 Pg. 1124-32 (Jun 2015) ISSN: 1531-5053 [Electronic] United States
• PMID: 25843816 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Analgesics
• Anti-Inflammatory Agents
• Glucocorticoids
• Diclofenac
• Dexamethasone

Topics

• Adolescent
• Adult
• Analgesics (therapeutic use)
• Anti-Inflammatory Agents (administration & dosage)
• Dexamethasone (administration & dosage)
• Diclofenac (therapeutic use)
• Double-Blind Method
• Edema (prevention & control)
• Female
• Follow-Up Studies
• Fracture Fixation, Internal (methods)
• Glucocorticoids (administration & dosage)
• Humans
• Injections
• Male
• Mandibular Fractures (surgery)
• Middle Aged
• Pain Measurement (methods)
• Pain, Postoperative (prevention & control)
• Postoperative Complications (prevention & control)
• Prospective Studies
• Range of Motion, Articular (drug effects)
• Trismus (prevention & control)
• Young Adult