A meta-analysis of dexamethasone use with tonsillectomy.
OBJECTIVE
To determine the quantitative impact of intravenous dexamethasone on recovery after tonsillectomy using established principles for meta-analysis.


METHODS
Double-blind randomized-control trials in which subjects were treated identically except for the presence or absence of perioperative intravenous dexamethasone. Six articles met inclusion criteria. Two investigators extracted data regarding postoperative emesis and return to a soft/regular diet.


RESULTS
Pooled analysis using a random effects model revealed a 27% decrease (P<0.00001) in postoperative emesis attributable to dexamethasone (95% CI, 12% to 42%). Dexamethasone increased the tolerance of a soft/regular diet at 24 hours by 22% (P< 0.001), but studies were heterogenous with low precision (95% CI, 1% to 44%).


CONCLUSIONS
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 heterogeneity among studies preclude definitive conclusions.


CONCLUSIONS
Perioperative dexamethasone administration had a positive impact on recovery from tonsillectomy.
Goldman
A C
AC
Department of Otolaryngology, SUNY-Health Science Center, Brooklyn, New York, USA.
Govindaraj
S
S
Rosenfeld
R M
RM
D000932:Antiemetics / Q000494:pharmacology / Q000627:therapeutic use*; D003907:Dexamethasone / Q000494:pharmacology / Q000627:therapeutic use*; D004032:Diet; D004311:Double-Blind Method; D006801:Humans; D007262:Infusions, Intravenous; D007430:Intraoperative Care / Q000379:methods*; D009017:Morbidity; D020250:Postoperative Nausea and Vomiting / Q000209:etiology* / Q000517:prevention & control*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012107:Research Design; D014068:Tonsillectomy / Q000009:adverse effects*; D016896:Treatment Outcome
D000932:Antiemetics; D003907:Dexamethasone