DEXAMETHASONE DECREASES VOMITING BY CHILDREN AFTER TONSILLECTOMY

We evaluated the effect of dexamethasone on vomiting after elective to nsillectomy in 133 healthy children aged 2-12 yr in a randomized, stra tified, blocked, double-blind, placebo-controlled study. General anest hesia was induced by inhalation of N2O and halothane or intravenously (IV) with propofol. Anesthesia was maintained with N2O and halothane. Dexamethasone 150 mu g/kg up to a maximum dose of 8 mg, or placebo, wa s administered IV before surgery. All patients received 1.5 mg/kg code ine intramuscularly (IM) intraoperatively. Perioperative IV fluids, ma nagement of emesis, postoperative pain and hospital discharge criteria were all standardized. The groups were similar with respect to number , age, weight, length of surgery, and estimated intraoperative blood l oss. Dexamethasone reduced the overall incidence of vomiting from 72% (placebo) to 40% (I) (P <0.001). Vomiting, both in-hospital and postdi scharge, was decreased by the prophylactic administration of dexametha sone. Each episode of in-hospital vomiting prolonged discharge by 13+/ -2 min, mean+/-SD (P <0.001). In conclusion, dexamethasone markedly de creased vomiting by healthy children after elective tonsillectomy in a n ambulatory hospital setting.