THE PROSPECTIVE EVALUATION OF PERIOPERATIVE STEROID DOSING ON POSTSURGICAL EDEMA IN ORTHOGNATHIC SURGERY
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Problem: While there exists good evidence to support steroid use, there is no consensus on the optimal dose of methylprednisolone to be used in orthognathic surgery. The purpose of this study is to investigate the postoperative effects of two perioperative doses of methylprednisolone in orthognathic surgery. Methods: A double-blinded randomized control evaluating 250 orthognathic surgery patients was conducted. Patients were randomized 1:1 to receive either a 1000mg dose or a 125mg dose of methylprednisolone perioperatively. Postoperative facial swelling was measured and secondary postoperative outcomes were recorded. Results: No significant difference in facial swelling was found between steroid groups (P= 0.42). Other than for mood (P= 0.05), no secondary outcomes differed between groups (all P > 0.05). In our study, younger age, male gender and BSSO procedures were associated with increased facial swelling. Conclusion: A perioperative dose of 125mg of methylprednisolone can be used as effectively as a 1000mg dose for the control of postoperative facial edema.