Dexamethasone and post-adenotonsillectomy pain in children: Double-blind, randomized controlled trial.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE

Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins

Adenoidectomy/*adverse effects ; Dexamethasone/*pharmacology ; Pain, Postoperative/*drug therapy ; Postoperative Nausea and Vomiting/*drug therapy ; Tonsillectomy/*adverse effects; Adenoidectomy/methods ; Anti-Inflammatory Agents/pharmacology ; Anti-Inflammatory Agents/therapeutic use ; Child ; Child, Preschool ; Dexamethasone/therapeutic use ; Double-Blind Method ; Female ; Humans ; Male ; Pain, Postoperative/etiology ; Pediatrics/methods ; Postoperative Nausea and Vomiting/etiology ; Republic of Korea ; Tonsillectomy/methods ; Visual Analog Scale

Objective: To assess the impact of intraoperative intravenous dexamethasone on the reduction of postoperative morbidity in children undergoing adenotonsillectomy.
Methods: A double blind randomized controlled trial conducted among children undergoing adenotonsillectomy at a tertiary hospital in Korea from November 2018 to June 2019. Children were randomly assigned to receive dexamethasone (0.5 mg/kg, maximum dose 24 mg) or placebo intravenously after induction of anesthesia. The primary endpoint was the reduction of postoperative pain and postoperative nausea and vomiting (PONV); secondary endpoints were adverse effects like postoperative hemorrhage.
Results: The study included 105 children, and 67 were male. Their mean age was 6.2 ± 2.1 years. There was no significant difference between the groups in terms of demographic data or the operation time. The pain scores of the dexamethasone group were lower than those of the control group, but no significant difference was found (all P > .05). The average pain visual analog scale (VAS) during the study period (day 0-7) was 3.67 ± 1.59 and 4.40 ± 2.01 in the dexamethasone group and control group, respectively (P-value = .107). When we compared early pain VAS (day 0-2) and late pain VAS (day 5-7), the dexamethasone group showed significantly lower early mean VAS compared to the control group (4.55 ± 1.78 vs 5.40 ± 2.05, P-value = .046). The mean VAS for PONV was significantly lower in the dexamethasone group than in the control group (1.89 ± 2.22 vs 3.00 ± 2.37, P value = .044).
Conclusion: In children undergoing adenotonsillectomy, dexamethasone decreased the early postoperative pain and PONV without increasing postoperative hemorrhage.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

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0 (Anti-Inflammatory Agents)
7S5I7G3JQL (Dexamethasone)

Date Created: 20210120 Date Completed: 20210126 Latest Revision: 20230103

20230104

PMC7808470

10.1097/MD.0000000000024122

33466183