下顎枝矢状分割法におけるデキサメタゾンの投与法の比較 : 各種血中サイトカイン濃度を指標として Comparative study of various methods for administering dexamethasone in bilateral sagittal split ramus osteotomy : analysis of serum levels of various cytokines
The effects of various administration methods on postoperative biological responses were determined by measuring serum levels of various cytokines. The subjects were 23 patients who underwent sagittal split ramus osteotomy at our department over a 1-year period from 2001 to 2002. These patients were randomly assigned to three groups with respect to dexamethasone (DM) administration: in 8 patients, DM was not administered before or after surgery (Group 1); in 7 patients, 8 mg of DM was administered just before surgery (Group 2); and in 8 patients, 8 mg of DM was administered just before surgery, 4 mg was administered immediately after surgery, and 2 mg was administered at 6 and 12 hours after surgery (Group 3). Clinical characteristics such as age, body weight, surgery time, anesthesia time, hemorrhage volume, transfusion volume, and urine volume were assessed. In addition, the concentrations or detection rates of serum TNF-α, IL-1β, IL-6, IL-8, IL-10, and IL-12 were determined. General blood tests were performed before, immediately after, and 1, 3, and 7 days after surgery. Because the levels of IL-1 βand IL-12 were generally below detection limits, detection rates were calculated for these cytokines. The IL-1βdetection rate in Group 3 was lower than that in the other two groups. The IL-12 detection rate in Group 1 was significantly higher than that in the other two groups, but there were no significant differences between Groups 2 and 3. As for the other cytokines, the TNF-αlevel immediately after surgery in Group 3 was significantly lower than that in Group 1. Similarly, the level of IL-6 1 day after surgery in Group 3 was significantly lower than that in Group 1. Thr levels of IL-10 immediately after surgery in Groups 2 and 3 were significantly higher than that in Group 1. The results showed that DM treatment before and after bilateral sagittal split ramus osteotomy suppressed the production of inflammatory cytokines without compromising immunocompetence. DM treatment before and after bilateral sagittal split ramus osteotomy was thus shown to be useful for attenuating postoperative inflammatory response immediately after surgery.
日本口腔外科学会雑誌 50(3), 175-184, 2004-03-20
Japanese Society of Oral and Maxillofacial Surgeons