Steroids for post-tonsillectomy pain reduction: meta-analysis of randomized controlled trials.
OBJECTIVE
To determine whether meta-analysis supports the use of corticosteroids to reduce post-tonsillectomy pain for pediatric patients.


METHODS
A systematic review of currently available randomized controlled trials using a single-dose, intravenous corticosteroid during pediatric tonsillectomy was performed. Visual analog pain scale (VAS) data was extracted with reviewers blinded to results. Meta-analysis was performed with weighted mean difference and random-effects model using Revman 4.2 software.


RESULTS
Eight randomized trials were included in analysis of post-tonsillectomy pain. A statistically significant reduction in pain as measured by VAS on postoperative day 1 was noted (mean VAS difference = -0.97; CI 95 % = -1.74,-0.19; P = 0.01).


CONCLUSIONS
A single, intraoperative dose of dexamethasone may reduce post-tonsillectomy pain on postoperative day 1, by a factor of 1 on a 10-point pain scale. As the side effects and cost of dexamethasone dose appear negligible, consideration of routine use seems reasonable.
Afman
Chad E
CE
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA. afmanc@UCMAIL.UC.EDU
Welge
Jeffrey A
JA
Steward
David L
DL
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D006801:Humans; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D014068:Tonsillectomy
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone