The impact of intravenous versus submucosal dexamethasone on short-term patient response: A randomized controlled trial.

IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of periodontology Pub Date : 2024-10-09 DOI:10.1002/JPER.24-0127
Ellen P Pearce, David E Deas, Charles A Powell, Anibal Diogenes, Georgios A Kotsakis, Michael J Mader, Archontia Palaiologou
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Abstract

Background: The purpose of this randomized, cross-over trial was to determine if a preoperative dose of dexamethasone administered submucosally is as effective as intravenous (IV) dexamethasone in reducing pain, swelling, and analgesic consumption after periodontal flap surgery.

Methods: Thirty-nine patients planned for two similar flap surgeries under IV sedation were included. Before the first surgery, patients were randomized to receive 8 mg of IV or submucosal dexamethasone. Via the alternate route, 0.9% sodium chloride (placebo) was administered. Dexamethasone was administered via the opposite route during the second surgery. A standardized regimen of 600 mg ibuprofen and 325 mg acetaminophen was used to manage postoperative pain. Patients recorded pain and swelling levels on a 21-point numerical rating scale (NRS-21) and a four-point visual rating scale (VRS-4), as well as analgesic usage via a phone application at 12, 24, 48, 72, and 168 h postoperatively.

Results: While NRS-21 and VRS-4 data suggest a trend toward decreased pain and swelling with IV administration, there were no significant differences in analgesic usage or pain at any time and a significant difference in swelling only at 72 h in favor of IV administration (p = 0.047).

Conclusions: There was no significant difference in pain or analgesic usage following periodontal flap surgery comparing IV and submucosal dexamethasone. A statistically significant difference in swelling between groups at 72 h is likely of limited clinical relevance. Submucosal dexamethasone is an effective way to mitigate pain following periodontal surgery, particularly when IV access for sedation is not required.

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静脉注射与粘膜下注射地塞米松对患者短期反应的影响:随机对照试验。
背景:这项随机交叉试验的目的是确定术前在黏膜下注射地塞米松是否与静脉注射地塞米松一样能有效减轻牙周皮瓣手术后的疼痛、肿胀和镇痛药用量:方法:39 名患者计划在静脉镇静下接受两次类似的翻瓣手术。在第一次手术前,患者被随机分配接受 8 毫克静脉注射或粘膜下地塞米松。通过备用途径,患者接受 0.9% 氯化钠(安慰剂)。第二次手术时,地塞米松通过相反的途径给药。采用 600 毫克布洛芬和 325 毫克对乙酰氨基酚的标准化方案来控制术后疼痛。患者在术后12、24、48、72和168小时分别用21点数字评分量表(NRS-21)和4点视觉评分量表(VRS-4)记录疼痛和肿胀程度,并通过手机应用软件记录镇痛药的使用情况:尽管NRS-21和VRS-4数据表明静脉注射有减轻疼痛和肿胀的趋势,但镇痛剂使用量或疼痛在任何时间都没有显著差异,只有在72小时时肿胀有显著差异,静脉注射更有利(p = 0.047):牙周翻瓣手术后,静脉注射地塞米松和粘膜下地塞米松在疼痛或镇痛剂用量上没有明显差异。72小时后各组间肿胀程度的统计学差异可能对临床意义有限。粘膜下地塞米松是减轻牙周手术后疼痛的有效方法,尤其是在不需要静脉注射镇静剂的情况下。
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来源期刊
Journal of periodontology
Journal of periodontology 医学-牙科与口腔外科
CiteScore
9.10
自引率
7.00%
发文量
290
审稿时长
3-8 weeks
期刊介绍: The Journal of Periodontology publishes articles relevant to the science and practice of periodontics and related areas.
期刊最新文献
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