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Effect of intravascular dexamethasone injection after powered intracapsular tonsillectomy and adenoidectomy in

Munsoo Han1, Min Kyu Lee1, Jun Yoo1

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.

American Journal of Otolaryngology
|February 12, 2022
PubMed

Insights

Intravenous dexamethasone did not significantly reduce pain, nausea, or vomiting after pediatric tonsillectomy and adenoidectomy (PITA). The study suggests dexamethasone may not be necessary for children undergoing PITA surgery.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Dexamethasone is a corticosteroid used to reduce inflammation and pain.
  • Its use in pediatric tonsillectomy and adenoidectomy (PITA) is being investigated for potential benefits.
  • The PITA technique is a modern approach to tonsil and adenoid removal.

Purpose of the Study:

  • To compare the effects of intravascular dexamethasone versus a control on postoperative pain, nausea, vomiting, and bleeding in children undergoing PITA.
  • To evaluate the efficacy of dexamethasone in mitigating common postoperative complications following PITA.

Main Methods:

  • A retrospective review of medical records for pediatric patients who underwent PITA between March 2017 and February 2021.
  • Pain and nausea were assessed using the Visual Analogue Scale (VAS) from postoperative day 0 to 6.
  • Analgesic use and vomiting episodes were recorded and statistically analyzed between the dexamethasone and control groups.

Main Results:

  • No statistically significant differences were observed in postoperative pain (p=0.169) or nausea (p=0.460) between the dexamethasone and control groups.
  • Postoperative analgesic requirements (p=0.398) and vomiting episodes (p=0.270) also showed no significant difference between the groups.
  • No instances of postoperative bleeding were reported in either group.

Conclusions:

  • Intravascular dexamethasone administration did not demonstrate significant benefits in reducing postoperative pain, nausea, or vomiting in children undergoing PITA.
  • The PITA technique itself may yield superior outcomes, potentially diminishing the need for adjunctive dexamethasone.
  • Otolaryngologists may not require routine preoperative dexamethasone administration for pediatric PITA procedures.
Abstract

Keywords:
DexamethasoneObstructive sleep apneaPostoperative nausea and vomitingPostoperative painTonsillectomy

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