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The effect of dexamethasone on postoperative vomiting after tonsillectomy
M T Aouad1, S S Siddik, L B Rizk
1Department of Anesthesiology, American University of Beirut, Beirut, Lebanon.
Insights
Dexamethasone significantly reduced vomiting and improved oral intake in children undergoing adenotonsillectomy. This study highlights the benefits of dexamethasone for pediatric post-operative recovery, leading to better patient satisfaction.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Post-tonsillectomy complications include vomiting and delayed oral intake.
- Effective management strategies are crucial for pediatric surgical recovery.
Purpose of the Study:
- To evaluate the efficacy of preoperative intravenous dexamethasone in reducing vomiting and improving oral intake in children undergoing adenotonsillectomy.
Main Methods:
- A double-blinded, randomized, placebo-controlled study involving 110 children aged 2-12 years.
- Participants received either dexamethasone (0.5 mg/kg IV) or saline preoperatively.
- Outcomes measured included vomiting incidence, time to oral intake, oral intake quality, satisfaction scores, and IV hydration duration.
Main Results:
- Dexamethasone group showed significantly lower overall and late vomiting incidence (23% and 19%) compared to the saline group (51% and 34%).
- Time to first oral intake and duration of IV hydration were shorter in the dexamethasone group (P < 0.05).
- Quality of oral intake and patient satisfaction scores were significantly better with dexamethasone (P < 0.05).
Conclusions:
- Preoperative intravenous dexamethasone is effective in reducing postoperative vomiting in children undergoing adenotonsillectomy.
- Dexamethasone improves oral intake, reduces the need for IV hydration, and enhances patient satisfaction.
- This supports the use of dexamethasone as an adjunct in pediatric adenotonsillectomy care.
Unlabelled:
In this double-blinded, randomized, placebo-controlled study, we assessed the effect of dexamethasone 0.5 mg/kg IV administered preoperatively in 110 children 2-12 yr old, undergoing electrodissection adenotonsillectomy, using a standardized anesthetic technique. The incidence of early and late vomiting, the time to first oral intake, the quality of oral intake, the satisfaction scores, and the duration of IV hydration were compared in both groups. The overall incidence of vomiting, as well as the incidence of late vomiting, was significantly less in the Dexamethasone group as compared with the Saline group (23% and 19% vs 51% and 34%, respectively). The time to first oral intake and the duration of IV hydration were shorter in the Dexamethasone group compared with the Saline group (P < 0.05). The quality of oral intake and the satisfaction scores were better in the Dexamethasone group than in the Saline group (P < 0.05). This report confirms the beneficial effect of IV dexamethasone on both vomiting and oral intake in children undergoing electrodissection adenotonsillectomy.
Implications:
In this double-blinded, placebo-controlled study, we examined the efficacy of a single dose of dexamethasone 0.5 mg/kg IV on posttonsillectomy vomiting and oral intake in children 2-12 yr old. Dexamethasone significantly decreased the incidence of postoperative vomiting during the first 24 h, shortened the time to the first oral intake and the duration of IV hydration, and improved the quality of oral intake and the satisfaction scores of the patients.