title: Use of dexamethasone to reduce postoperative vomiting and pain after pediatric tonsillectomy procedures.
abstract: OBJECTIVE
  The purpose of this study is to determine whether a single dose of dexamethasone 0.5mg/kg administered before surgery could decrease post operative vomiting and pain and improves oral intake in the first 24-hours after pediatric tonsillectomy procedures.
  
  
  METHODS
  It is a randomized, double blind, placebo controlled study. Sixty children age 2-12-years ASA 1 and 11 were scheduled for tonsillectomy, dexamethasone (n=29) and control group (n=31) were enrolled in the study. Dexamethasone group received 0.5mg/kg intravenous dexamethasone and control group received saline at the time of induction. The anesthetic regimen and surgical procedures were standardized for all patients. All patients were observed in post anesthesia care unit (PACU) and ward for post operative vomiting, pain, need for rescue antiemetic or analgesia and time for first oral intake for 24-hours.
  
  
  RESULTS
  Data from 60 patients were analyzed. The overall incidence of early as well as late vomiting was significantly less in dexamethasone as compared to control group (37% versus 74% P=0.016), overall incidence of retching was 29% in control and 3.4% in dexamethasone (p=0.008). Vomiting once or more than once was significantly high in control as compared to dexamethasone group. The need for rescue antiemetic, the time to first oral intake and analgesic requirements did not show any significant difference in both groups.
  
  
  CONCLUSIONS
  Dexamethasone is considered safe and there was no adverse effects associated with a single dose of dexamethasone. Although the need for rescue antiemetic, time to oral intake and analgesia requirements in both groups were not significant, however, we found that dexamethasone does have antiemetic properties as overall incidence of retching and vomiting was significantly less in dexamethasone group as compared to control group in children who underwent tonsillectomy.
authors.affiliation: Department of Anesthesia, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Abdulhamid H
authors.initials: AH
authors.lastname: Samarkandi
authors.forename: Mussarat A
authors.initials: MA
authors.lastname: Shaikh
authors.forename: Rana A
authors.initials: RA
authors.lastname: Ahmad
authors.forename: Ahmed Y
authors.initials: AY
authors.lastname: Alammar
mesh_terms: D000932:Antiemetics / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control*; D011292:Premedication; D012529:Saudi Arabia; D014068:Tonsillectomy; D016896:Treatment Outcome
chemical_list: D000932:Antiemetics; D003907:Dexamethasone