The effect of dexamethasone on postoperative vomiting and oral intake after adenotonsillectomy

Post-operative nausea and vomiting following paediatric day-case tonsillectomy: audit of the Epsom protocol

“…[13][14][15] When combined with dexamethasone, ondansetron has been reported to prevent nausea and vomiting almost completely. When used together, these two drugs are relatively free of significant adverse effects.…”

The Steroid Controversy: Where Are We?

“…PONV may necessitate overnight hospital admission for intravenous hydration and pain control, and leads to increased costs and decreased patient satisfaction [18,19,20]. A single dose of intraoperative dexamethasone has been clearly demonstrated to have potent antiemetic effects in the perioperative setting [5,8,9,11,12,13,14,21,22,23]. The aforementioned Cochrane study demonstrated that, compared with placebo, children receiving dexamethasone were less likely to vomit in the first 24 h (relative risk, RR, 0.54; 95% confidence interval, CI, 0.42-0.69) and were more likely to advance to a soft or solid diet on postoperative day 1 (RR, 1.69; 95% CI, 1.02-2.79) [5].…”

“…In 2008, prior to the existence of any steroid controversy, there was a wealth of literature in favor of giving intraoperative steroids during pediatric tonsillectomy to prevent postoperative nausea and vomiting [6,7,8,9,10,11,12,13,14]. Few studies existed with demonstrative data suggesting adverse consequences of perioperative dexamethasone administration.…”

Current Management of Vomiting After Tonsillectomy in Children

“…Propofol, dexamethasone, and midazolam, as nontraditional antiemetics, are used for the prevention of POV in children undergoing tonsillectomy with or without adenoidectomy [15][16][17][18][19][20][21][22][23][24][25][26][27][28] (Table 2).…”

“…Similarly, Tom et al [20], April et al [21], and Papas et al [22] found the antiemetic efficacy of dexamethasone 1 mg kg -1 (maximum 10, 16, and 25 mg) for the prevention of POV. Preoperative dexamethasone 0.4-0.5 mg kg -1 (maximum 8 mg) reduced the incidence of POV [23][24][25][26]. To determine the minimum effective dose of dexamethasone in prevention POV after tonsillectomy in children, Michelles et al compared the 5 doses (0.0625, 0.125, 0.25, 0.5, and 1 mg kg -1 ) of dexamethasone.…”