Dexamethasone decreases vomiting by children after tonsillectomy

Area of Science:

• Pediatric Anesthesiology
• Pharmacology
• Surgical Outcomes

Background:

• Post-tonsillectomy nausea and vomiting (PONV) are common in children.
• Effective antiemetic strategies are crucial for pediatric ambulatory surgery.
• Dexamethasone is a potential agent for managing PONV.

Purpose of the Study:

• To evaluate the efficacy of dexamethasone in preventing vomiting after elective tonsillectomy in children.
• To assess the impact of dexamethasone on in-hospital and post-discharge vomiting.
• To determine the effect of vomiting episodes on hospital discharge time.

Main Methods:

• A randomized, double-blind, placebo-controlled trial involving 133 children aged 2-12 years undergoing tonsillectomy.
• Participants received either intravenous dexamethasone (150 mcg/kg, max 8 mg) or placebo before surgery.
• Standardized anesthesia, intraoperative codeine, fluid management, and discharge criteria were applied.

Main Results:

• Dexamethasone reduced the overall incidence of vomiting from 72% in the placebo group to 40% (P < 0.001).
• Prophylactic dexamethasone decreased both in-hospital and post-discharge vomiting episodes.
• Each in-hospital vomiting episode prolonged discharge by an average of 13 minutes (P < 0.001).

Conclusions:

• Dexamethasone is highly effective in reducing vomiting after elective tonsillectomy in healthy children.
• Prophylactic dexamethasone administration improves recovery and shortens discharge time in pediatric ambulatory tonsillectomy.
• This finding supports the use of dexamethasone as an antiemetic in pediatric tonsillectomy settings.