title: A randomized clinical trial of the effects of submucosal dexamethasone after surgery for mandibular fractures.
abstract: OBJECTIVE
  To evaluate the effects of immediate postoperative submucosal dexamethasone administration on postoperative pain, edema, trismus, and mandibular functions after open reduction and internal fixation (ORIF) for mandibular fractures.
  
  
  METHODS
  We conducted a prospective, randomized, controlled, double-blind study of 40 patients who required ORIF for mandibular fractures under general anesthesia. The patients were divided into 2 groups, an experimental group (n = 20) who received immediate postoperative submucosal 8 mg of dexamethasone through the surgical incision site, and a control group (n = 20) who did not receive dexamethasone. Pain was assessed using a visual analog scale (VAS) score and the frequency of analgesic consumption at the various postoperative intervals. The maximum interincisal distance and facial measurements were compared before surgery and at 24, 48, and 72 hours and 7 days after surgery. The difficulty in mandibular function after surgery was graded as mild, moderate, or severe.
  
  
  RESULTS
  The analgesic drugs required 2 hours after surgery and the VAS score 72 hours after surgery were significantly less (P < .05) in the experimental group than in the control group. The total number of diclofenac tablets required by the experimental group was less than that for the control group, but the difference was not statistically significant. The control group had significantly increased swelling (P < .05) compared with the experimental group from preoperatively to 24 hours postoperatively (experimental group 0.115 ± 0.143, control group 0.253 ± 0.173). No statistically significant difference was present in the mouth opening or difficulty in mandibular function at the different follow-up intervals between the 2 groups (P > .05).
  
  
  CONCLUSIONS
  The results of our study suggest that submucosal administration of dexamethasone after ORIF for mandibular fractures is effective in reducing postoperative pain and edema.
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal. Electronic address: ashokdongol@hotmail.com.
authors.forename: Ashok
authors.initials: A
authors.lastname: Dongol
authors.affiliation: Associate Professor and Head of Department, Department of Oral and Maxillofacial Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Mehul Rajesh
authors.initials: MR
authors.lastname: Jaisani
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Leeza
authors.initials: L
authors.lastname: Pradhan
authors.affiliation: Former Resident, Department of Oral and Maxillofacial Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Sanad
authors.initials: S
authors.lastname: Dulal
authors.affiliation: Additional Professor, Department of Oral and Maxillofacial Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Alok
authors.initials: A
authors.lastname: Sagtani
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage*; D004008:Diclofenac / Q000627:therapeutic use; D004311:Double-Blind Method; D004487:Edema / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007267:Injections; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000187:drug effects; D014313:Trismus / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000700:Analgesics; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D004008:Diclofenac; D003907:Dexamethasone