Effects Of Low-Dose Versus Standard-Dose Intravenous Dexamethasone On Postoperative Vomiting, Nausea And Pain In Children Undergoing Tonsillectomy: A Randomised, Controlled, And Blind Trial
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Abstract
Background: Tonsillectomy among the children is often linked to postoperative nausea and vomiting (PONV) and pain that may slow down the recovery and accelerate hospital readmissions. Dexamethasone has been proved to decrease the morbidity after surgery, but the optimal dose is still unknown. Methods: This is a prospective, randomized and double-blind study in which 76 children aged between 2 and 8 years undergoing elective tonsillectomy were selected to receive anaesthetic induction at intravenous dexamethasone 0.15 mg kg-1, dexamethasone 0.5 mg kg -1, and placebo. The main outcome was the occurrence of PONV, whereas additional outcomes were postoperative pain and analgesics needs. Results: Both dose levels of dexamethasone decreased the case of rescue anti-emetic treatment significantly when compared with placebo (P = 0.012). There were no substantial differences in the two doses of dexamethasone. The analgesic needs in the postoperative period did not differ between groups and yet the pain scores rose on the second day of postoperation in patients treated with dexamethasone. Conclusion: Dexamethasone at a single low dose as an IV bolus is effective in the reduction of PONV following paediatric tonsillectomy and does not increase adverse events.
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References
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