Analgesic Effect of Perioperative Systemic Dexamethasone on Blowout Fracture Surgery

Purpose: To clarify the effect of systemic dexamethasone (DXM) on pain and postoperative opioid (oxycodone) consumption after blowout fracture surgery. Materials and Methods: A prospective randomized observer-blinded trial of 20 patients who had a blowout fracture requiring surgical intervention was conducted. Patients were randomly assigned to receive a total dose of intravenous DXM 30 mg perioperatively or no DXM (controls). Pain was assessed postoperatively using a 10-cm visual analog scale (VAS) each time analgesics (acetaminophen every 6 hours or oxycodone upon request) were administered. The VAS area under the curve (VAS AUC) for 24 hours postoperatively represented the outcome. Data were analyzed using chi(2) test, Student t test, 2-tailed Mann-Whitney U test, and linear regression, with a P value less than .05 indicating significance. Results: Patients with blowout fracture receiving perioperative systemic DXM exhibited a significantly lower average VAS AUC (P = .04). After controlling for other confounding variables, this result remained significant (P = .03). Conclusions: DXM appears to decrease postoperative pain and thus is recommended as a pre-emptive analgesic in blowout fracture surgery. (C) 2017 Published by Elsevier Inc on behalf of the American Association of Oral and Maxillofacial SurgeonsPeer reviewe