OBJECTIVE: To determine the quantitative impact of intravenous dexamethason
e on recovery after tonsillectomy using established principles for metaanal
ysis.
STUDY DESIGN/SETTING: Double-blind randomized-control trials in which subje
cts were treated identically except for the presence or absence of perioper
ative intravenous dexamethasone. Six articles met inclusion criteria. Two i
nvestigators extracted data regarding postoperative emesis and return to a
soft/regular diet.
RESULTS: Pooled analysis using a random effects model revealed a 27% decrea
se (P < 0.00001) in postoperative emesis attributable to dexamethasone (95%
CI, 12% to 42%). Dexamethasone increased the tolerance of a soft/regular d
iet at 24 hours by 22% (P < 0.001), but studies were heterogenous with low
precision (95% Ct, 1% to 44%).
CONCLUSION: To prevent emesis in 1 child after tonsillectomy, approximately
4 children must receive perioperative dexamethasone. An additional benefit
is earlier tolerance of a soft/regular diet, but low precision and heterog
eneity among studies preclude definitive conclusions.
SIGNIFICANCE: Perioperative dexamethasone administration had a positive imp
act on recovery from tonsillectomy.