[The effect of steroid therapy on post adenotonsillectomy recovery].
BACKGROUND
Previous studies on dexamethasone's antiemetic and antinflammatory potential in patients undergoing adenotonsillectomy have produced conflicting results.


OBJECTIVE
To determine the effect of intraoperative I.V. single dose dexamethasone on recovery and complications after adenotonsillitis while anesthesia techniques, surgical techniques and perioperative treatment are standardized.


METHODS
Prospective randomized, controlled study.


METHODS
A total of 230 patients aged 2-16 years undergoing elective adenotonsillectomy enrolled in the study. Patients were randomly assigned to receive i.v. dexamethasone 0.5 mg/kg (study group), or no treatment (control group). Pain score, emesis, oral intake and bleeding were assessed on the first and tenth postoperative day.


RESULTS
Overall, 204 completed the study, 101 in the study group, 103 in the control group. It was found that intraoperative single I.V. dexamethasone significantly reduces emesis during the first postoperative day (P < 0.0001), significantly reduces pain score on the first (P < 0.0001), and tenth postoperative day (P = 0.053), significantly increases the number of patients returning to soft diet on the first postoperative day (P = 0.0002) and normal diet on the tenth postoperative day (P < 0.0001). No significant difference in bleeding tendency between the two groups was noted (P = 0.7202).


CONCLUSIONS
Intraoperative injection of I.V. dexamethasone 0.5 mg/kg effectively reduced post adenotonsillectomy morbidity.
Kaufmann
Michal
M
Department of Otorhinolaryngology, Head & Neck Surgery Bikur Cholim Hospital Jerusalem, Israel. ilan_y@012.net.il
Deutsch
Elimelech
E
Hamouri
Halil
H
D000233:Adenoidectomy; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D017558:Elective Surgical Procedures; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D010149:Postoperative Pain / Q000517:prevention & control*; D011184:Postoperative Period; D014068:Tonsillectomy; D014839:Vomiting / Q000517:prevention & control*
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone