Impact of steroids on recovery after uvulopalatopharyngoplasty

Objective: To determine whether perioperative systemic corticosteroid admin istration can reduce uvulopalatopharyngoplasty (UPPP) postoperative morbidi ties (e.g., pain, anorexia, sleep disturbance, mouth odor, and fatigue) or reduce narcotic analgesic usage. Study Design: A prospective, double-blinde d study with random assignment of treatment agent (placebo or corticosteroi d). Methods: From 1995 to 1998, a consecutive sample of 48 adults presentin g for elective UPPP surgery alone or in combination with tonsillectomy or s eptoplasty, or both, were enrolled. Twenty-eight subjects completed the pro tocol and were equally distributed by random assignment to intramuscular (I M) and intravenous (IV) doses of placebo (saline) or corticosteroid (60 mg methylprednisolone IM and 12 mg dexamethasone IV). Acetaminophen with codei ne analgesic was available to both groups as needed. Subjects recorded a di ary of symptom severity scores over the first postoperative week relating t o eight commonly reported morbidities (1-4 points) and the daily quantity o f narcotic consumed. Results: Statistical comparison (Wilcoxon's rank sum t est) showed no significant differences between subjects treated with placeb o or corticosteroid on postoperative day 1 or 7, Three subjects (21%) in ea ch treatment group reported no postoperative use of narcotic analgesic. Con clusions: No statistically or clinically significant benefits were derived from perioperative systemic corticosteroid treatment in this sample of 28 a dults treated with UPPP alone or in combination with tonsillectomy or septo plasty, or both. Some individuals tolerate post-UPPP discomfort without a n arcotic analgesic.