Objective
To determine the effects of a single dose of dexamethasone sodium phosphate on postoperative morbidity in children undergoing tonsillectomy.
Design
Randomized, double-blind, placebo-control clinical trial.
Setting
Academic, tertiary care children's hospital.
Patients
Sixty-nine children (35 boys, 34 girls), aged 3 to 18 years, undergoing tonsillectomy, with or without adenoidectomy.
Intervention
Patients were randomized to receive a single dose of intravenous dexamethasone or saline.
Main Outcome Measures
Pain scores, determined by a Faces Scale, were obtained at 4-hour intervals during the first postoperative day and daily for 7 days thereafter. Total use of an analgesic; type of diet; level of activity; presence of halitosis, nausea, emesis, or fever; and incidence of postoperative bleeding were also compared between the two groups.
Results
The two groups of children were similar in age, gender, diagnosis, and surgical time. Pain scores in the postoperative period were identical while the patients were in the hospital and for the first 7 days after discharge. No statistically significant differences were noted in pain scores, nausea, emesis, halitosis, analgesic medications required, diet, or activity levels between the two groups of patients.
Conclusion
A single intraoperative dose of dexamethasone did not appreciably affect postoperative morbidity in children undergoing tonsillectomy.
(Arch Otolaryngol Head Neck Surg. 1995;121:737-742)
Brian Weston
From the Departments of Otolaryngology (Dr Ohlms and Mr Weston) and Anesthesia (Dr Wilder), Children's Hospital, and the Departments of Otology and Laryngology (Dr Ohlms and Mr Weston) and Anesthesia (Dr Wilder), Harvard Medical School, Boston, Mass. Dr Ohlms is now with the Department of Otolaryngology, Texas Children's Hospital, Baylor College of Medicine, Houston.
Dexamethasone and Risk of Nausea and Vomiting and Postoperative Bleeding After Tonsillectomy in Children: A Randomized Trial
Czarnetzki et al.
JAMA 2008;300:2621-2630.
ABSTRACT
| FULL TEXT
There Is No Dose-Escalation Response to Dexamethasone (0.0625-1.0 mg/kg) in Pediatric Tonsillectomy or Adenotonsillectomy Patients for Preventing Vomiting, Reducing Pain, Shortening Time to First Liquid Intake, or the Incidence of Voice Change
Kim et al.
Anesth. Analg. 2007;104:1052-1058.
ABSTRACT
| FULL TEXT
Prophylaxis of postoperative vomiting in children undergoing tonsillectomy: a systematic review and meta-analysis
Bolton et al.
Br J Anaesth 2006;97:593-604.
ABSTRACT
| FULL TEXT
Ondansetron Oral Disintegrating Tablets: Acceptability and Efficacy in Children Undergoing Adenotonsillectomy
Cohen et al.
Anesth. Analg. 2005;101:59-63.
ABSTRACT
| FULL TEXT
Perioperative Steroids in Tonsillectomy Using Electrocautery and Sharp Dissection Techniques
Hanasono et al.
Arch Otolaryngol Head Neck Surg 2004;130:917-921.
ABSTRACT
| FULL TEXT
Efficacy of Gastric Aspiration in Reducing Posttonsillectomy Vomiting
Jones et al.
Arch Otolaryngol Head Neck Surg 2001;127:980-984.
ABSTRACT
| FULL TEXT
Perioperative Intravenous Steroid Treatment and Tonsillectomy
Heatley
Arch Otolaryngol Head Neck Surg 2001;127:1007-1008.
FULL TEXT
Tonsillectomy and Postoperative Vomiting: Do Steroids Really Work?
Shott
Arch Otolaryngol Head Neck Surg 2001;127:1009-1010.
FULL TEXT
Corticosteroid Therapy During Endoscopic Sinus Surgery in Children: Is There a Need for a Second Look?
Ramadan
Arch Otolaryngol Head Neck Surg 2001;127:188-192.
ABSTRACT
| FULL TEXT
Postoperative Tonsillectomy Pain in Pediatric Patients: Electrocautery (Hot) vs Cold Dissection and Snare Tonsillectomy-- A Randomized Trial
Nunez et al.
Arch Otolaryngol Head Neck Surg 2000;126:837-841.
ABSTRACT
| FULL TEXT
Effect of Steroids on Posttonsillectomy Pain in Adults
Carr et al.
Arch Otolaryngol Head Neck Surg 1999;125:1361-1364.
ABSTRACT
| FULL TEXT
