Impact of steroids on recovery after uvulopalatopharyngoplasty.
OBJECTIVE
To determine whether perioperative systemic corticosteroid administration can reduce uvulopalatopharyngoplasty (UPPP) postoperative morbidities (e.g., pain, anorexia, sleep disturbance, mouth odor, and fatigue) or reduce narcotic analgesic usage.


METHODS
A prospective, double-blinded study with random assignment of treatment agent (placebo or corticosteroid).


METHODS
From 1995 to 1998, a consecutive sample of 48 adults presenting for elective UPPP surgery alone or in combination with tonsillectomy or septoplasty, or both, were enrolled. Twenty-eight subjects completed the protocol and were equally distributed by random assignment to intramuscular (IM) and intravenous (IV) doses of placebo (saline) or corticosteroid (60 mg methylprednisolone IM and 12 mg dexamethasone IV). Acetaminophen with codeine analgesic was available to both groups as needed. Subjects recorded a diary of symptom severity scores over the first postoperative week relating to eight commonly reported morbidities (1-4 points) and the daily quantity of narcotic consumed.


RESULTS
Statistical comparison (Wilcoxon's rank sum test) showed no significant differences between subjects treated with placebo or corticosteroid on postoperative day 1 or 7. Three subjects (21%) in each treatment group reported no postoperative use of narcotic analgesic.


CONCLUSIONS
No statistically or clinically significant benefits were derived from perioperative systemic corticosteroid treatment in this sample of 28 adults treated with UPPP alone or in combination with tonsillectomy or septoplasty, or both. Some individuals tolerate post-UPPP discomfort without a narcotic analgesic.
Williams
P M
PM
Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, Ohio 44195, USA.
Strome
M
M
Eliachar
I
I
Lavertu
P
P
Wood
B G
BG
Vito
K J
KJ
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D010160:Palate, Soft / Q000503:physiopathology / Q000601:surgery*; D010614:Pharynx / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000503:physiopathology / Q000601:surgery*; D012913:Snoring / Q000503:physiopathology / Q000601:surgery*; D014068:Tonsillectomy; D014609:Uvula / Q000503:physiopathology / Q000601:surgery*
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D008775:Methylprednisolone