Analgesic Effect of Perioperative Systemic Dexamethasone on Blowout Fracture Surgery

Purpose To clarify the effect of systemic dexamethasone (DXM) on pain and postoperative opioid (oxycodone) consumption after blowout fracture surgery. Materials and Methods A prospective randomized observer-blinded trial of 20 patients who had a blowout fracture requiring surgical intervention was conducted. Patients were randomly assigned to receive a total dose of intravenous DXM 30 mg perioperatively or no DXM (controls). Pain was assessed postoperatively using a 10-cm visual analog scale (VAS) each time analgesics (acetaminophen every 6 hours or oxycodone upon request) were administered. The VAS area under the curve (VAS AUC) for 24 hours postoperatively represented the outcome. Data were analyzed using χ 2 test, Student t test, 2-tailed Mann-Whitney U test, and linear regression, with a P value less than .05 indicating significance. Results Patients with blowout fracture receiving perioperative systemic DXM exhibited a significantly lower average VAS AUC ( P  = .04). After controlling for other confounding variables, this result remained significant ( P  = .03). Conclusions DXM appears to decrease postoperative pain and thus is recommended as a pre-emptive analgesic in blowout fracture surgery.