[Do corticotherapy and hemodilution decrease postoperative inflammation after maxillofacial surgery?].
OBJECTIVE
To assess the efficiency of corticosteroids and preoperative acute normovolaemic haemodilution (PANHD) in reducing postoperative inflammation after maxillofacial surgery.


METHODS
Randomized clinical trial.


METHODS
Thirty-two patients scheduled to undergo maxillary osteotomy for facial dysmorphia were randomized into four groups of eight (PANHD or not; corticosteroids or not).


METHODS
PANHD decreased haematocrit to 30%. In the corticosteroid groups, methylprednisolone 1.5 mg.kg-1 was given intravenously at the beginning of surgery (after PANHD in haemodiluted group), and after surgery, 1.5 mg.kg-1 iv daily for three days. Postoperative inflammation was assessed with an X-Ray technique (radiotelemetry) providing data on tissue thickness (extent of facial oedema), and by measurement of plasma concentrations of four acute phase proteins during the first postoperative week.


RESULTS
No change in facial oedema and in acute phase proteins occurred with PANHD. Corticosteroids decreased postoperative oedema and acute phase proteins.


CONCLUSIONS
Corticosteroids decrease postoperative inflammation after maxillofacial surgery but not PANHD.
Peillon
D
D
Département d'anesthésie-réanimation, centre hospitalier Lyon-Sud, Pierre-Bénite, France.
Dubost
J
J
Roche
C
C
Bienvenu
J
J
Breton
P
P
Carry
P Y
PY
Freidel
M
M
Banssillon
V
V
D000209:Acute-Phase Proteins / Q000032:analysis; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D005147:Facial Bones / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D010027:Osteotomy; D011183:Postoperative Complications; D012886:Skull / Q000002:abnormalities / Q000601:surgery*
D000209:Acute-Phase Proteins; D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone
La corticothérapie et l'hémodilution diminuent-elles l'inflammation postopératoire après chirurgie maxillofaciale?