Comparison of the Effectiveness of Dexamethasone Injection into Two Different Sites in Preventing the Postoperative Complications after Mandibular Third Molar Surgery: A Randomized Clinical Trial.

Aims: Inflammation occurring after the surgical removal of impacted lower third molars can cause complications such as pain and swelling. The aim of this study was to compare the effectiveness of dexamethasone injection into the medial pterygoid and gluteal muscles in preventing postoperative complications after surgical removal of bony impacted mandibular third molars. Study Design: Parallel randomized clinical trial. Place and Duration of Study: Oral Surgery Department of the Torabinejad Dental Research Center, between April 2013 and January 2014. Methodology: This trial included 77 participants aged between 18 and 35 years [mean age (mean ± standard deviation), 25.04±4.33 years] requiring surgical removal of a single bony impacted mandibular third molar under local anesthesia. Participants were randomly assigned to 3 groups based on systematic random. Postoperative pain, swelling, patients’ general satisfaction, and changes in daily life function were evaluated. These factors were first analyzed by the Kruskal–Wallis and ANOVA tests, followed by the Mann–Whitney test. Results: The two dexamethasone groups had significantly less postoperative pain, swelling, and change in appearance at 48 h after the surgery compared with the DF group. Conclusion: With the caution of a small sample size, the results of this study indicate that near the surgical field preoperative injection of dexamethasone in the medial pterygoid muscle can control postoperative pain, swelling, and changes in appearance as efficiently as the same in the gluteus muscle.

Rationality and normativity of the package insert of dexamethasone injection related to medication safety / 中国药学杂志

OBJECTIVE: To evaluatethe rationality and normativity of the contents of thepackage insert of dexamethasoneinjectionrelated to medicationsafety, thus to facilitate the rational use of dexamethasoneinjection. METHODS: The contentsof dosage and administration, adverse drug reaction, and precautionsin the package insert of dexamethasoneinjectionwere reviewed, and the rationality and normativity of the contents were discussed according tothe published papers and the clinical medication practice in our hospital. RESULTS: The contents of the package insert of dexamethasone injectionwere simple, some of the expressionswereambiguousor not standard. Dexamethasone is a long-acting glucocorticoid drug, which has a great influence on human glucose metabolism, while the effect of water and sodium retention is weak. Using 5% glucose injection as the solvent of dexamethasone as stated in the package insertmay exacerbate hyperglycemia, and 0.9% sodium chloride injection should generally be used as the dilution solvent. Besides, when the stock solution is directly injected intravenously, the adverse reactionsof gastrointestinal tract and nervous system may be aggravated. Additionally, there was no precaution statement in the package insert that dexamethasonemay induce hypokalemia in a minority of patients even at single low dose. CONCLUSION: Package insertsof drugs are legal instruments and the most important evidence to guide the rational use of medications. Therefore, it is suggested that the package insert of dexamethasoneinjection should be further improved and revised, which will be of great significance in the implementation of clinical guidelines of glucocorticoids applicationand the rational use of glucocorticoids.

The efficacy of dexamethasone injection on postoperative pain in lower third molar surgery

BACKGROUND: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. METHODS: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. RESULTS: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. CONCLUSIONS: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.

The efficacy of dexamethasone injection on postoperative pain in lower third molar surgery

BACKGROUND: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. METHODS: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. RESULTS: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. CONCLUSIONS: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.