Prophylactic use of dexamethasone in tonsillectomy among children

In this double blind, randomized placebo-controlled study, the effect of dexamethasone in two different doses 0.5mg/kg and 1mg/kg on prevention of postoperative vomiting in children undergoing tonsillectomy with or with out adenoidectomy by electrodissection was evaluated. One hundred fifty children were involved in this study; children were allocated randomly into three equal groups. Children received either 1.V dexamethasone 0.5mg/kg with maximum total dose 8mg (group Dl), or dexamethasone 1mg/kg with maximal total dose 16 mg (group D2) or 2 ml normal saline, with induction of anesthesia. The incidence of early and late vomiting, the time to first oral intake, postoperative pain score and parent satisfaction scores were compared between groups. The over all incidence of postoperative vomiting episodes was less in the two dexamethasone groups compared to the saline group (Dl 22%, D2 18%. saline 46%), also the time to first oral intake was shorter in the dexamethasone groups. Satisfaction scores were better in dexamethasone groups compared to saline group P<0.05. The VAS pain scores were significantly less in the two dexamethasone groups at 2, 4, 6 hours postoperatively. There was no significant difference between the two dexamethasone groups in all measured parameters, indicating that I.V dexamethasone 0.5 mg/kg was as effective as dexamethasone 1 mg/kg to reduce the incidence of postoperative vomiting, time to first oral intake, and postoperative pain with increased parent satisfaction among children undergoing tonsillectomy by electrodissection.