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Effect of Steroids on Posttonsillectomy Pain in Adults
Michele M. Carr, DDS, MD, MEd, FRCSC;
Jason G. Williams, BSc;
Laura Carmichael, RN, BN;
Joseph G. Nasser, DDS, MD, MS, MRCDC, FRCSC
Arch Otolaryngol Head Neck Surg. 1999;125:1361-1364.
Objective To determine whether a single intraoperative dose of intravenous dexamethasone has an effect on pain after tonsillectomy.
Design Double-blinded randomized controlled clinical trial.
Subjects Thirty-four consecutive nonpediatric patients presenting for tonsillectomy.
Intervention Patients scheduled for electrocautery tonsillectomy were randomized to receive either intravenous dexamethasone or placebo during surgery. Pain was measured twice daily for 10 days by means of a visual analog scale.
Results There were no statistically significant differences between the groups, but the dexamethasone group had a trend to report less pain over the first several days. The dexamethasone group received less analgesic in the recovery room, but there were no differences between the groups in the 10 days afterward.
Conclusions There is evidence that a single dose of dexamethasone reduces pain after tonsillectomy to a small degree. A single dose was not associated with adverse effects, so the risk-benefit ratio may be favorable for this practice.
From the Department of Pediatric Otolaryngology, Children's Hospital of Buffalo, NY (Dr Carr); Department of Otolaryngology, Dalhousie University, Halifax, Nova Scotia (Dr Nasser); and Department of Otolaryngology–Head and Neck Surgery, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia (Ms Carmichael and Dr Nasser). Mr Williams is a medical student at Dalhousie University.
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