BackgroundThe 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.MethodsThirty‐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.ResultsWhile 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).ConclusionsThere 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.

中文翻译：

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静脉注射与粘膜下注射地塞米松对短期患者反应的影响：一项随机对照试验


背景这项随机、交叉试验的目的是确定术前粘膜下注射地塞米松剂量在减轻牙周皮瓣手术后的疼痛、肿胀和镇痛药消耗方面是否与静脉注射 （IV） 地塞米松一样有效。方法纳入 39 例计划在 IV 镇静下进行 2 次类似皮瓣手术的患者。在第一次手术前，患者被随机分配接受 8 mg IV 或粘膜下地塞米松。通过替代途径，给予 0.9% 氯化钠（安慰剂）。在第二次手术中，地塞米松通过相反的途径给药。使用 600 mg 布洛芬和 325 mg 对乙酰氨基酚的标准化方案来控制术后疼痛。患者在 21 点数字评定量表 （NRS-21） 和 4 点视觉评定量表 （VRS-4） 上记录疼痛和肿胀水平，并在术后 12 、 24 、 48 、 72 和 168 小时通过电话应用程序记录镇痛药使用情况。结果虽然 NRS-21 和 VRS-4 数据表明静脉注射后疼痛和肿胀有减轻的趋势，但镇痛药的使用或疼痛在任何时间都没有显着差异，仅在 72 小时肿胀存在显着差异，有利于静脉注射 （p = 0.047）。结论与 IV 和粘膜下地塞米松相比，牙周瓣手术后疼痛或镇痛药的使用没有显著差异。72 小时时组间肿胀的统计学显着差异可能具有有限的临床相关性。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通路进行镇静时。