Page 44 - MDA SCATE 2023 Programme Book

ORAL PRESENTATION ABSTRACTS

METABOLIC AND ENDOCRINAL EFFECTS OF SUBMUCOSAL DEXAMETHASONE
Abstract 13 INJECTION FOR MANDIBULAR THIRD MOLAR (MTM) SURGERY IN HOSPITAL
SULTANAH NORA ISMAIL - A PRELIMINARY STUDY

Zhi Chuan Yong
Hospital Sultanah Nora Ismail, Batu Pahat

Studies on systemic effects of local steroid injection in other parts of body have shown significant, albeit
transient, systemic effects on glucose metabolism and Hypothalamus-pituitary-adrenal (HPA) axis. No
study was done on systemic effects of submucosal steroid injection in the oral cavity. Our study objective
is to assess the systemic effects of submucosal dexamethasone injection for mandibular third molar (MTM)
surgery on glucose metabolism and HPA axis of healthy patients in Hospital Sultanah Nora Ismail.
Methods: 23 subjects planned for MTM surgery were recruited. Baseline fasting morning serum cortisol,
fasting and 2-hour post-prandial capillary blood sugar (CBS), were taken 1 week before MTM surgery. MTM
surgery were performed 15 minutes after submucosal injection of 8 mg dexamethasone. Blood investigations
were repeated on Day 1, 7 and 21 after procedure. Systemic effects of submucosal steroid injection were
evaluated by comparing values between baseline and post-procedural values of blood investigations.
Results: Median values of fasting morning serum cortisol for baseline, Day 1,7 and 21 were 10.4, 0.7, 10.1 and
10.5 respectively. Median values for fasting CBS for baseline, Day 1, 7 and 21 were 5.1, 5.5, 5 and 5 respectively,
while median value for 2-hour post prandial CBS were 5.5, 5.8, 5.4 and 5.4 respectively. Wilcoxon signed-rank
test showed significant difference in values between fasting serum cortisol for baseline and Day 1 (P<0.001,)
and fasting CBS for baseline and Day 1 (P=0.006).
Discussion/Conclusion: Submucosal dexamethasone injection results in significant HPA axis depression
only on Day 1 after procedure. Similar no significant differences were not detected for CBS. More studies
need to be done in patients such as well-controlled diabetics to ascertain its safe use in them.

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