Effect of steroids on posttonsillectomy pain in adults

Objective: To determine whether a single intraoperative dose of intravenous dexamethasone has an effect on pain after tonsillectomy. Design: Double-blinded randomized controlled clinical trial. Subjects: Thirty-four consecutive nonpediatric patients presenting for tons illectomy. Intervention: Patients scheduled for electrocautery tonsillectomy were rand omized to receive either intravenous dexamethasone or placebo during surger y. Pain was measured twice daily for 10 days by means of a visual analog sc ale. Results: There were no statistically significant differences between the gr oups, but the dexamethasone group had a trend to report less pain over the first several days. The dexamethasone group received less analgesic in the recovery room, but there were no differences between the groups in the 10 d ays afterward. Conclusions: There is evidence that a single dose of dexamethasone reduces pain after tonsillectomy to a small degree. A single dose was not associate d with adverse effects, so the risk-benefit ratio may be favorable for this practice.