Steroid therapy for post-tonsillectomy symptoms in adults: a randomized, placebo-controlled study

Post-operative morbidity following tonsillectomy remains an important clinical problem despite advances in anesthetic and surgical techniques. This study investigated the effect of a one-day course of intravenous dexamethasone on recovery from tonsillectomy.

In a double-blind, randomized, placebo-controlled trial, 30 consecutive adult patients between 18 and 35 years of age, who had no previous or known contraindications to steroid therapy, were randomly assigned at the time of surgery to either a 24-hour course of dexamethasone (3 doses of 6 mg IV) or placebo with the first dose administered during surgery, and subsequent doses given after 8 and 16 hours. The same surgeon treated all patients. Postoperative signs and symptoms, including pain, nausea, vomiting, progress of healing and the degree of granulation, were evaluated for 2 weeks.

Patients treated with dexamethasone showed significantly less pain, nausea and vomiting, better healing and less granulation. There were no side effects reported.

Application of 3 doses of dexamethasone within 24 hours during and after tonsillectomy is advisable because of the reduction of postoperative morbidity, especially pain and edema.