Background
Dexamethasone is widely used in the prevention of postoperative complications in oral surgery and strengthening the analgesic effect after anesthesia, but the efficacy is controversial, and the relationship between postoperative complications and pain is still unclear. The purpose of this study was to evaluate the analgesic effect of dexamethasone in the treatment of jaw cyst and to explore the relationship between postoperative complications and pain.
Methods
We conducted a prospective, randomized, double-blind clinical trial. 120 patients were divided into two groups, dexamethasone group ( group D) and control group (Group C). All patients were given 0.02mg/kg of hydromorphone to relieve pain in advance at 10 minutes before the beginning of operation. Meanwhile, dexamethasone was injected 0.2mg/kg intravenously in group D and normal saline was injected in group C. The primary endpoint was pain intensity at 2h, 6h, 12h, 24h and 48h after surgery. The secondary endpoints were the incidence and extent of complications after surgery, including facial swelling and trismus.
Results
Compared with group C, the VAS scores at rest at 2, 6, 12 and 24 h after surgery and during mobilization at 2h, 6h, 12h, 24h and 48h after surgery in group D were significantly lower (P < 0.05). The degree of facial swelling and trismus in group D at 12, 24 and 48 h after surgery was significantly lower than that in group C (P < 0.05), but there was no difference at 6 hours after operation (P > 0.05). The C-reactive protein (CRP) level at 24 h after operation in group D was lower than group C (P < 0.05), but there was no significant difference in blood glucose concentration between the two groups (P > 0.05).
Conclusion
Dexamethasone can reduce the degree of facial swelling and trismus after jaw cyst surgery by inhibiting the production of inflammation, which alleviated the postoperative pain of patients significantly. In addition, it did not increase the risk of hyperglycemia.
Trial registration:
This study was registered with the Chinese Clinical Trial Registry on May 07, 2020 (URL: http://www.chictr.org.cn/showproj.aspx?proj=53344. Registry number: ChiCTR2000032693 ). Registered on 07/05/2020.