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The Effect of Dexamethasone on Pain Severity After Zygomatic Complex Fractures

Kormi, Eeva, MD, DDS*; Thorén, Hanna, MD, PhD†,‡; Snäll, Johanna, MD, PhD*; Törnwall, Jyrki, MD, PhD*

Journal of Craniofacial Surgery: May 2019 - Volume 30 - Issue 3 - p 742–745
doi: 10.1097/SCS.0000000000005188
Original Articles
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The authors sought to assess the effect of systemic perioperative dexamethasone (DXM) on pain severity after zygomatic complex (ZC) fracture surgery. To achieve this, the authors conducted a prospective randomized observer-blinded trial on 63 patients with isolated ZC fracture requiring surgical intervention. Patients randomly received either perioperative systemic DXM (10 or 30 mg), or served as controls receiving no DXM, and postoperative pain severity was assessed. Pain was measured with a 10 cm visual analogue scale (VAS) each time that analgesics (1 g paracetamol 4 times daily or oxycodone upon request) were administered, and analyzed as the area under the VAS curve for the immediate postoperative 24 hours. This further divided experienced pain into 2 categories (mild, or moderate to severe) using VAS = 4 as the cutoff. For statistics the authors used χ2 test, Mann–Whitney U test, and logistic regression analysis, setting significance at P < 0.05. Zygomatic complex fracture patients receiving perioperative systemic DXM experienced milder pain compared with controls (P = 0.04). Subgroups receiving DXM (10 or 30 mg) reported no statistical difference regarding pain (P = 0.43). Overall, patients receiving DXM experienced less pain, thus DXM may be recommended as pre-emptive analgesic. Nonetheless, considering the possible adverse effects, a 10 mg single dose may be sufficient.

*Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki and Department of Oral and Maxillofacial Surgery, Päijät-Häme Joint Authority for Health and Wellbeing, Lahti

Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku

Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland.

Address correspondence and reprint requests to Eeva Kormi, MD, DDS, Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, PB 220, Helsinki, 00029 HUS, Finland. Present address: Department of Oral and Maxillofacial Surgery, Keskussairaalankatu 7, 15850 Lahti, Finland; E-mail: eeva.kormi@gmail.com

Received 19 June, 2018

Accepted 11 November, 2018

The writing of this manuscript was partly funded by grant from Paulo Foundation.

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.