USE OF INTRAOPERATIVE CORTICOSTEROIDS IN PEDIATRIC TONSILLECTOMY

Objective: To determine the effects of a single dose of dexamethasone sodium phosphate on postoperative morbidity in children undergoing ton sillectomy. Design: Randomized, double-blind, placebo-control clinical trial. Setting: Academic, tertiary care children's hospital. Patients : Sixty-nine children (35 boys, 34 girls), aged 3 to 18 years, undergo ing tonsillectomy, with or without adenoidectomy. Intervention: Patien ts were randomized to receive a single dose of intravenous dexamethaso ne or saline. Main Outcome Measures: Pain scores, determined by a Face s Scale, were obtained at 4-hour intervals during the first postoperat ive day and daily for 7 days thereafter. Total use of an analgesic; ty pe of diet; level of activity; presence of halitosis, nausea, emesis, or fever; and incidence of postoperative bleeding were also compared b etween the two groups. Results: The two groups of children were simila r in age, gender, diagnosis, and surgical time. Pain scores in the pos toperative period were identical while the patients were in the hospit al and for the first 7 days after discharge. No statistically signific ant differences were noted in pain scores, nausea, emesis, halitosis, analgesic medications required, diet, or activity levels between the t wo groups of patients. Conclusion: A single intraoperative dose of dex amethasone did not appreciably affect postoperative morbidity in child ren undergoing tonsillectomy.