title: Comparison of local and intravenous dexamethasone for postoperative pain and recovery after tonsillectomy.
abstract: OBJECTIVE
  To compare local infiltration of dexamethasone to intravenous injection for postoperative pain and recovery after tonsillectomy.
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  Second Affiliated Hospital of Harbin Medical University.
  
  
  METHODS
  Children (n=240, American Society of Anesthesiologists [ASA] classes I-II, aged 5-10 y) scheduled for tonsillectomy were randomly and equally assigned to 3 groups: DEX-IV, for intravenous injection of dexamethasone (0.5 mg/kg, maximum dose 24 mg); DEX-INF, given the same amount of dexamethasone by local infiltration to the upper middle and lower poles of the tonsils; and a control group not given dexamethasone. Postoperative pain was scored at intervals from 30 minutes to 24 hours. The time to first administration of analgesic and average consumption of analgesic, times to first oral water and solid food intake, and incidence rates of nausea and vomiting were evaluated.
  
  
  RESULTS
  From postoperative 1 to 16 hours, the DEX-INF group had significantly lower pain scores than did the DEX-IV group, and the time to first analgesic and average consumption of analgesic were also significantly lower. The times to first oral water and food intake in the DEX-INF group were significantly shorter than in the DEX-IV group. The incidence of nausea and vomiting in the DEX-INF group was higher than that of the DEX-IV group.
  
  
  CONCLUSIONS
  Local infiltration of dexamethasone was more effective than systemic administration to decrease pain and time to food intake, but the antiemetic effect was less.
  
  
  BACKGROUND
  ChiCTR-TRC-13003535.
authors.affiliation: Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Nangang District of Harbin, Harbin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Nangang District of Harbin, Harbin, China.
authors.forename: Qin Rui
authors.initials: QR
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Nangang District of Harbin, Harbin, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Nangang District of Harbin, Harbin, China gaowei20055@126.com gengjieying1403008@163.com.
authors.forename: Jie Ying
authors.initials: JY
authors.lastname: Geng
mesh_terms: D000287:Administration, Topical; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D020127:Recovery of Function; D014068:Tonsillectomy; D016896:Treatment Outcome
chemical_list: D003907:Dexamethasone
keywords: dexamethasone; pain; tonsillectomy