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Use of dexamethasone to reduce postoperative vomiting and pain after pediatric tonsillectomy procedures

Abdulhamid H Samarkandi1, Mussarat A Shaikh, Rana A Ahmad

  • 1Department of Anesthesia, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.

Saudi Medical Journal
|December 2, 2004
PubMed

Insights

A single dose of dexamethasone significantly reduced post-operative vomiting and retching in children undergoing tonsillectomy. While not impacting pain or oral intake, dexamethasone demonstrated clear antiemetic properties in pediatric patients.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Surgical Outcomes

Background:

  • Post-tonsillectomy nausea and vomiting (PONV) are common complications in pediatric patients.
  • Effective management of PONV is crucial for patient recovery and satisfaction.
  • Dexamethasone is a corticosteroid with known antiemetic potential.

Purpose of the Study:

  • To evaluate the efficacy of a single pre-operative dose of dexamethasone (0.5mg/kg) in reducing post-operative vomiting and pain.
  • To assess the impact of dexamethasone on oral intake within 24 hours after pediatric tonsillectomy.
  • To determine the safety profile of peri-operative dexamethasone administration in children.

Main Methods:

  • A randomized, double-blind, placebo-controlled study involving 60 children (aged 2-12 years) undergoing tonsillectomy.
  • Patients received either intravenous dexamethasone (n=29) or saline placebo (n=31) at anesthetic induction.
  • Standardized anesthetic and surgical protocols were followed, with observation for vomiting, pain, antiemetic/analgesic use, and oral intake for 24 hours.

Main Results:

  • The incidence of vomiting was significantly lower in the dexamethasone group (37%) compared to the control group (74%) (P=0.016).
  • Retching occurred significantly less frequently in the dexamethasone group (3.4%) versus the control group (29%) (p=0.008).
  • No significant differences were observed between groups regarding the need for rescue antiemetics, time to first oral intake, or analgesic requirements.

Conclusions:

  • A single pre-operative dose of dexamethasone is safe and well-tolerated in pediatric tonsillectomy patients, with no adverse effects noted.
  • Dexamethasone exhibits significant antiemetic properties, effectively reducing the incidence of vomiting and retching post-tonsillectomy.
  • While not significantly improving pain control or oral intake, the antiemetic effect of dexamethasone is a valuable benefit in this patient population.
Abstract

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