Use of intravenous steroids at induction of anaesthesia for adult tonsillectomy to reduce post-operative nausea and vomiting and pain: a double-blind randomized controlled trial.
OBJECTIVE
To assess the effectiveness of intravenous steroids at induction of anaesthetic to reduce post-operative nausea and vomiting and pain after adult tonsillectomy.


METHODS
Prospective, double-blind, randomized, placebo controlled trial, with ethical approval, following Consolidated Standards of Reporting Trials guidelines.


METHODS
District General Hospital in Scotland, UK.


METHODS
Seventy-two adults between 16 and 70 years, American Association of Anaethetists (ASA) 1, listed for elective tonsillectomy.


METHODS
Single dose of either 10 mg of dexamethasone or 2 mL of saline after induction with a consistent anaesthetic technique.


METHODS
Patients filled in a visual analogue scale relating to pain and post-operative nausea and vomiting for the day of operation and 7 days after operation. The time to first ingestion of food and drink after operation was also noted.


RESULTS
Data completion rate of 64% (46 of 72 patients enrolled). Statistically significant relative decrease (62%P = 0.001) in the incidence of post-operative nausea and vomiting was seen in those treated with dexamethasone. Statistically significant relative decrease (23%P = 0.016) in post-operative pain scores for the day of operation was seen in those treated with dexamethasone. Significant decrease (17.5%, P < 0.001) in mean pain score for seven post-operative days was seen in those treated with dexamethasone. No adverse effects were seen.


CONCLUSIONS
Dexamethasone given as a single dose of 10 mg at induction of anaesthesia for adult tonsillectomy is an effective, safe and inexpensive method for reducing morbidity in adult tonsillectomy.
McKean
S
S
Department of Otorhinolaryngology, Victoria Hospital, Kirkcaldy, Scotland. simon@jazzle.co.uk
Kochilas
X
X
Kelleher
R
R
Dockery
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000932:Antiemetics / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D007546:Isoquinolines; D008297:Male; D008875:Middle Aged; D000077590:Mivacurium; D003473:Neuromuscular Nondepolarizing Agents; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000517:prevention & control*; D015742:Propofol; D014068:Tonsillectomy / Q000009:adverse effects*; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D000893:Anti-Inflammatory Agents; D000932:Antiemetics; D005938:Glucocorticoids; D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium; D003907:Dexamethasone; D015742:Propofol