Administration of Intravenous Dexamethasone for Prevention of Postoperative Swelling in Bilateral Sagittal Split Ramus Osteotomy Setback (BSSRO SETBACK) Patients: A Double-Blind, Randomized Controlled Trial

Main Article Content

Thanabhon Jenjarat
Siripong Sittisomwong
Porjai Pattanittum
Pattaramon Rattanaphan

Abstract

Dexamethasone is commonly used to reduce post-operative swelling in orthognathic surgery patients. However, the effective administration dose of dexamethasone is still controversial among studies. The objective of this study is to study the efficacy and side effects of different administration doses of intravenous dexamethasone on reducing post-operative swelling and serum C-reactive protein levels. 14 patients (2 male, 12 female, age 19-42 years) undergoing BSSRO setback surgery at Faculty of Dentistry, Khon Kaen University during May 2019 to December 2020 had participated in this study. 4 patients were randomized into the control group (no dexamethasone). 5 patients in the first study group received 8 mg of intravenous dexamethasone at 30-60 minutes pre-operatively and 3 times post-operatively (total dose 32 mg) and 5 patients in the second study group received 16 mg of intravenous dexamethasone at 30-60 minutes pre-operatively (total dose 16 mg). The facial measurement method was used to record post-operative swelling at 4 time points: pre-operative and 24 hours, 48 hours, and 14 days post-operatively. Side effects following dexamethasone administration were also collected. The study results showed that there was no statistical difference in facial swelling between both study groups and control group. Meanwhile, the C-reactive protein level in the 8-mg ×4 dexamethasone group was lower than the control group with statistical significance. None of the side effects was found in this study.

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Jenjarat T, Sittisomwong S, Pattanittum P, Rattanaphan P. Administration of Intravenous Dexamethasone for Prevention of Postoperative Swelling in Bilateral Sagittal Split Ramus Osteotomy Setback (BSSRO SETBACK) Patients: A Double-Blind, Randomized Controlled Trial. Khon Kaen Dent J [Internet]. 2022 Mar. 16 [cited 2022 Dec. 5];25(1):1-13. Available from: https://he01.tci-thaijo.org/index.php/KDJ/article/view/248892
Section
Research Articles
Share |

References

Qayyum Z, Aslam A, Yunus M, Rahman P, Luqman U, Shah AA. Intra operative complications of sagittal split ramus osteotomy. POJ 2014;6(2):65-71.

Weber CR, Griffin JM. Evaluation of dexamethasone for reducing postoperative edema and inflammatory response after orthognathic surgery. J Oral Maxillofac Surg 1994;52(1):35-9.

Drew SJ. Best practices for management of pain, swelling, nausea, and vomiting in dentoalveolar surgery. Oral Maxillofac Surg Clin N Am 2015;27(3): 393-404.

Gasperini G, Rodrigues de Siqueira IC, Rezende Costa L. Does low-level laser therapy decrease swelling and pain resulting from orthognathic surgery? Int J Oral Maxillofac Surg 2014;43(7):868-73.

Shetty V, Mohan A. A prospective, randomized, double-blind, placebo-controlled clinical trial comparing the efficacy of systemic enzyme therapy for edema control in orthognathic surgery using ultrasound scan to measure facial swelling. J Oral Maxillofac Surg 2013;71(7):1 261-7.

Tozzi U, Santillo V, Tartaro GP, Sellitto A, Gravino GR, Santagata M. A prospective, randomized, double-blind, placebo-controlled clinical trial comparing the efficacy of anti-edema drugs for edema control in orthognathic surgery using digitizer 3-D to measure facial swelling. J Maxillofac Oral Surg. 2015;14(2):386-92.

Kormi E, Snäll J, Törnwall J, Thorén H. A survey of the use of perioperative glucocorticoids in oral and maxillofacial durgery. J Oral Maxillofac Surg 2016; 74(8):1548-51.

Munro IR, Boyd JB, Wainwright DJ. Effect of Steroids in Maxillofacial Surgery. Ann Plast Surg 1986;17(5):440-1.

Peillon D, Dubost J, Roche C, Bienvenu J, Breton P, Carry PY, et al. La corticothérapie et l’hémodilution diminuent-elles l’inflammation postopératoire après chirurgie maxillofaciale? Ann Fr Anesth Réanimation 1996;15(2):157-61.

Hye-Young Kim L-JL. Effect of steroid for the postoperative swelling after orthognathic surgery 2011 Aug 28; Available from: https://clinicaltrials.gov/ct2/ show/study/NCT01431014

Haraji A, Hozhabr H, Valaei N. Effect of sub-mucosal injection of dexamethasone on post-operative edema after bilateral sagittal split ramus osteotomy (BSSRO). J Res Dent Sci 2014;10(4(38)):241-5.

Widar F, Kashani H, Alsén B, Dahlin C, Rasmusson L. The effects of steroids in preventing facial oedema, pain, and neurosensory disturbances after bilateral sagittal split osteotomy: a randomized controlled trial. Int J Oral Maxillofac Surg 2015;44(2):252-8.

Dongol A, Jaisani MR, Pradhan L, Dulal S, Sagtani A. A randomized clinical trial of the effects of submucosal dexamethasone after surgery for mandibular fractures. J Oral Maxillofac Surg 2015;73(6):1124-32.

Kumar Malhari A, Sharma R, Rattan V. Role of corticosteroids in reduction of post-operative oedema in craniofaciomaxillary surgery. J Evol Med Dent Sci 2016 16;5(48):3090-103.

Abukawa H, Ogawa T, Kono M, Koizumi T, Kawase-Koga Y, Chikazu D. Intravenous dexamethasone administration before orthognathic surgery reduces the postoperative edema of the masseter muscle: a randomized controlled trial. J Oral Maxillofac Surg 2017;75(6):1257-62.

Buchner A, Erdfelder E, Faul F, Lang A-G. Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009; 41(4):1149-60.

Lin HH, Kim SG, Kim HY, Niu LS, Lo LJ. Higher Dose of dexamethasone does not further reduce facial swelling after orthognathic surgery: a randomized controlled trial using 3-dimensional photogrammetry. Ann Plast Surg. 2017;78(3):S61-9.

Dan AEB, Thygesen TH, Pinholt EM. Corticosteroid administration in oral and orthognathic surgery: a systematic review of the literature and meta-analysis. J Oral Maxillofac Surg 2010:68(9):2207-20.

Semper-Hogg W, Fuessinger MA, Dirlewanger TW, Cornelius CP, Metzger MC. The influence of dexamethasone on postoperative swelling and neurosensory disturbances after orthognathic surgery: a randomized controlled clinical trial. Head Face Med 2017;13(1):19.

Snäll J, Törnwall J, Suominen AL, Thorén H. Behavior of C-reactive protein in association with surgery of facial fracture and the influence of dexamethasone. Oral Maxillofac Surg 2018;22(2):129-34.

Gozali P, Kiattavornchareon S, Wu M, Wongsirichat N, Suphangul S. Betamethasone and methylprednisolone usage in lower third molar surgery: review literature 2015;35(3):8.

Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol 2018;9:754

Aher V, Chander P, Ali F. C-reactive protein a better indicator of inflammation after third molar extraction. Niger J Clin Pract 2013;16(3):297.

Akashi M, Furudoi S, Hashikawa K, Sakakibara A, Hasegawa T, Shigeta T, et al. Postoperative abnormal response of C-reactive protein as an indicator for infectious complications after oral oncologic surgery with primary reconstruction. J of Otolaryngol-Head & Neck Surg 2015;44(1):13.

Srivastava N, Shetty A, Kumar P, Rishi D, Bagga V, Kale SG. Comparison of preemptive effect of dexamethasone and methylprednisolone after third molar surgery: a split- mouth randomized triple-blind clinical trial. J Maxillofac Oral Surg 2021;20(2):264-70

Jean S, Dionne PL, Bouchard C, Giasson L, Turgeon AF. Perioperative systemic corticosteroids in orthognathic surgery: s systematic review and meta-analysis. J Oral Maxillofac Surg 2017;75(12):2638-49.