A randomized clinical trial of the effects of submucosal dexamethasone after
surgery for mandibular fractures.
Author(s): Dongol A(1), Jaisani MR(2), Pradhan L(3), Dulal S(4), Sagtani A(5).
Affiliation(s): Author information:
(1)Assistant Professor, Department of Oral and Maxillofacial Surgery, BP Koirala
Institute of Health Sciences, Dharan, Nepal. Electronic address:
ashokdongol@hotmail.com. (2)Associate Professor and Head of Department,
Department of Oral and Maxillofacial Surgery, BP Koirala Institute of Health
Sciences, Dharan, Nepal. (3)Assistant Professor, Department of Oral and
Maxillofacial Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal.
(4)Former Resident, Department of Oral and Maxillofacial Surgery, BP Koirala
Institute of Health Sciences, Dharan, Nepal. (5)Additional Professor, Department
of Oral and Maxillofacial Surgery, BP Koirala Institute of Health Sciences,
Dharan, Nepal.
Publication date & source: 2015, J Oral Maxillofac Surg. , 73(6):1124-32
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.
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