EFFECT OF CORTICOSTEROIDS AND HEMODILUTIO N ON POSTOPERATIVE INFLAMMATION AFTER MAXILLOFACIAL SURGERY

Objective: To assess the efficiency of corticosteroids and preoperativ e acute normovolaemic haemodilution (PANHD) in reducing postoperative inflammation after maxillofacial surgery. Study design: Randomized cli nical trial. Patients: Thirty-two patients scheduled to undergo maxill ary osteotomy for facial dysmorphia were randomized into four groups o f eight (PANHD or not; corticosteroids or not). Methods: PANHD decreas ed haematocrit to 30%. In the corticosteroid groups, methylprednisolon e 1.5 mg . kg(-1) was given intravenously at the beginning of surgery (after PANHD in haemodiluted group), and after surgery, 1.5 mg . kg(-1 ) iv daily for three days. Postoperative inflammation was assessed wit h an X-Ray technique (radiotelemetry) providing data on tissue thickne ss (extent of facial oedema), and by measurement of plasma concentrati ons of four acute phase proteins during the first postoperative week. Results: No change in facial oedema and in acute phase proteins occurr ed with PANHD. Corticosteroids decreased postoperative oedema and acut e phase proteins. Conclusion: Corticosteroids decrease postoperative i nflammation after maxillofacial surgery but not PANHD.