Preoperative administration of dexamethasone alleviates swelling and pain within the first postsurgery week after periodontal surgery.

This trial aimed to explore if a preoperative intravenous dose of dexamethasone minimizes pain, swelling, and analgesic use after periodontal flap surgery.

This randomized controlled, crossover trial incorporated 37 individuals planned for 2 identical periodontal  surgeries under intravenous sedation. Participants were segregated to receive 2 mL (8mg) dexamethasone sodium phosphate or 2 mL of intravenous solution (placebo) before the 1st operation, and 2 mL of the other solution before the 2nd  operation.

Using a standardized regimen of ibuprofen (600 mg) and acetaminophen (325 mg), the management of postsurgery discomfort was done. A smartphone application was utilized for recording self-evaluated pain and swelling scores using 21-point numerical (NRS-21) and 4-point verbal (VRS-4) rating scales, and also the number of analgesics at 12-, 24-, 48-, 72-, 168-, and 336-hours after each operation.

The NRS-21 data indicated that dexamethasone is linked with a considerable decline in swelling (at 12, 24, 48, and 168 hours) and pain (at 12, 24, 48, and 72 hours) after surgery in comparison with placebo.

After surgery, the VRS-4 data illustrated a remarkable decrease in swelling (at 12, 24, and 168 hours) and pain (at 12, 72, and 168 hours) with dexamethasone. There were no vital differences in the no. of tablets of acetaminophen or ibuprofen between both groups.

Intravenous dexamethasone seems to be a valuable adjunct for perioperative management of pain and swelling in patients undergoing periodontal flap surgery.