The Effect of Postoperative Single-Dose Intravenous Dexamethasone on Common Complications After Tonsillectomy in Children: A Randomized Controlled Trial

Abstract

Background: Tonsillectomy is associated with early and late postoperative complications in the children. Previous studies have shown some effects of dexamethasone; however, there has been a lack of studies that evaluate its effects on other complications, including odynophagia and otalgia. Objectives: We aimed to investigate the effects of dexamethasone on odynophagia and otalgia after surgery. Patients and Methods: In this randomized clinical trial, 100 patients who underwent adenotonsillectomy were divided into two groups: one group received 0.1 mg/kg of dexamethasone (case) and the other received Ringer serum as a placebo (control). Intravenous (IV) dexamethasone was prescribed to be administered by a nurse on the ward. The incidence of bleeding, nausea and vomiting, odynophagia, voice change, acetaminophen intake, halitosis and otalgia, and activity were evaluated at 24 h and during the first 7 days after surgery. Results: The mean ages of patients were 7.1 ± 2.8 and 6.5 ± 2.4 years in the control and case groups, respectively. The overall proportions of females and males were 41% and 59%, respectively. No significant difference in demographic data was seen between the two groups (P > 0.05). There was a significant difference in terms of odynophagia and nausea and vomiting between the case and control groups after 24 h (P = 0.001). There was no significant difference between the case and control groups in terms of bleeding, voice change, halitosis, or nausea and vomiting after 7 days (P > 0.05). Meanwhile, there were a significant difference in the incidence of acetaminophen intake (60% vs. 30%, P = 0.002), odynophagia (24% vs. 6%, P = 0.011), otalgia (20% vs. 4%, P = 0.014), and activity (80% vs. 98%, P = 0.004) of patients after 7 days between the groups. Conclusions: In children undergoing adenotonsillectomy, dexamethasone has a significant antiemetic effect and decreases odynophagia, otalgia, and the need for analgesia.