Intravenous dexamethasone administration before orthognathic surgery reduces the postoperative edema of the masseter muscle: a randomized controlled trial

Publication date: Available online 9 January 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Harutsugi Abukawa, Takashi Ogawa, Michihide Kono, Toshiyuki Koizumi, Yoko Kawase-Koga, Daichi Chikazu
PurposeDexamethasone (dex) seems to suppress postoperative swelling. However, the standard administration dose of dex for bilateral sagittal split osteotomies (BSSOs) has not been reported. This study focused to understand the most effective dose of dex for BSSOs.Materials and MethodsThis research was planned as a prospective randomized controlled double-blind study. Patients undergoing BSSOs were randomly assigned and received intravenous preoperative dex under 3 different dose conditions: 16 mg, 8 mg, and 0 mg (control). The endpoints of this study were postoperative changes in a) masseter muscle thickness and buccal soft tissue, b) maximum incisal opening, c) sensation of the chin and lower lip region, d) blood examinations (WBCs, neutrophils, CRP, and lymphocytes), and d) types of complications. Data were recorded at 2 to 4 time intervals: i) before surgery); ii) postoperative day 1; iii) postoperative day 2; iv) postoperative day 3. Average age, gender, average body mass index, average surgery time, and average blood loss were also examined. Data were analyzed using one-way analysis of variance (Bonferroni's Multiple Comparison Test) after Bartlett's test.ResultsTwenty-four patients including 5 men and 19 women were enrolled in this study. The rate of increase (ROI) in the thickness of masseter muscle 24 hours after BSSOs was 38.4% in the 16 mg group (n = 8), 57.7% in the 8 mg group (n = 8), and 56.1% in the 0 mg group (n = 8). The ROI in the thickness of masseter muscle in the 16 mg group was significantly lower than that in the 0 mg group (P < .05). The number of lymphocytes after surgery shown that the 16 mg and 8 mg groups maintained preoperative levels in the number of lymphocytes, whereas there was a reduced number of lymphocytes in the control group. No statistically significant results were obtained for the study endpoints b) and c).ConclusionThis investigation demonstrated that the most effective dose of dex for BSSOs is 16 mg.



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