Intravenous Dexamethasone Administration Before Orthognathic Surgery Reduces the Postoperative Edema of the Masseter Muscle: A Randomized Controlled Trial
Intravenous Dexamethasone Administration Before Orthognathic Surgery Reduces the Postoperative Edema of the Masseter Muscle: A Randomized Controlled Trial
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DOI：
10.1016/j.joms.2016.12.048
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发表时间：
2017-06-01
影响因子：
1.9
通讯作者：
Chikazu, Daichi
中科院分区：
文献类型：
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作者：
Abukawa, Harutsugi;Ogawa, Takashi;Chikazu, Daichi
目的：地塞米松似乎可以抑制术后肿胀。然而，双侧矢状劈开截骨术(BSSO)中地塞米松的标准给药剂量尚未见报道。本研究的重点是明确地塞米松治疗 BSSO 的最有效剂量。材料和方法：本研究计划为一项前瞻性、随机对照、双盲研究。接受 BSSO 的患者被随机分配接受 3 种不同剂量条件下的术前静脉注射地塞米松：16 mg、8 mg 和 0 mg（对照）。本研究的终点是1）术后咬肌厚度和颊侧软组织厚度的变化； 2）术后最大切口开口的变化； 3）术后下巴和下唇区域的感觉变化； 4）术后血液检查结果（白细胞计数、中性粒细胞计数、C反应蛋白水平、淋巴细胞计数）的变化； 5) 并发症的类型。以2至4个时间间隔记录数据：手术前、术后第1天、术后第2天和术后第3天。还检查了平均年龄、性别、平均体重指数、平均手术时间和平均失血量。 Bartlett 检验后，通过单因素方差分析（Bonferroni 多重比较检验）对数据进行分析。结果：我们在本研究中纳入了 24 名患者，其中包括 5 名男性和 19 名女性。 BSSO后24小时咬肌厚度增加率为16 mg组（n = 8）38.4％，8 mg组（n = 8）57.7％，0 mg组（n = 8）56.1％。 16 mg 组咬肌厚度增加率显着低于 0 mg 组 (P < .05)。关于术后淋巴细胞数量，16 mg 和 8 mg 组维持术前水平，而对照组淋巴细胞数量减少。以下研究终点没有获得统计学上显着的结果：术后最大切口开口的变化以及术后下巴和下唇区域感觉的变化。结论：这项研究表明，地塞米松治疗 BSSO 的最有效剂量是 16 mg。 (C) 2017年美国口腔颌面外科医师协会
Purpose: Dexamethasone seems to suppress postoperative swelling. However, the standard administration dose of dexamethasone for bilateral sagittal split osteotomy (BSSO) has not been reported. This study focused on clarifying the most effective dose of dexamethasone for BSSO.Materials and Methods: This research was planned as a prospective, randomized controlled, doubleblind study. Patients undergoing BSSO were randomly assigned to receive intravenous preoperative dexamethasone under 3 different dose conditions: 16 mg, 8 mg, and 0mg (control). The endpoints of this study were 1) postoperative changes in masseter muscle thickness and buccal soft tissue thickness; 2) postoperative changes in maximum incisal opening; 3) postoperative changes in sensation of the chin and lower lip region; 4) postoperative changes in blood examination findings (white blood cell count, neutrophil count, C-reactive protein level, and lymphocyte count); and 5) types of complications. Data were recorded at 2 to 4 time intervals: before surgery, postoperative day 1, postoperative day 2, and postoperative day 3. Average age, gender, average body mass index, average surgery time, and average blood loss also were examined. Data were analyzed by 1-way analysis of variance (Bonferroni multiple-comparisons test) after the Bartlett test.Results: We enrolled 24 patients, including 5 men and 19 women, in this study. The rate of increase in the thickness of the masseter muscle 24 hours after BSSO 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 rate of increase in masseter muscle thickness in the 16-mg group was significantly lower than that in the 0-mg group (P < .05). Regarding the number of lymphocytes after surgery, the 16-mg and 8-mg groups maintained preoperative levels whereas there was a reduced number of lymphocytes in the control group. No statistically significant results were obtained for the following study endpoints: postoperative changes in maximum incisal opening and postoperative changes in sensation of the chin and lower lip region.Conclusions: This investigation showed that the most effective dose of dexamethasone for BSSO is 16 mg. (C) 2017 American Association of Oral and Maxillofacial Surgeons