Dexamethasone in adenotonsillectomy

Tom, Lawrence W. C.; Templeton, John Y.; Thompson, Mary; Marsh, Roger R.

doi:10.1016/0165-5876(96)01388-2

Cited by 90 publications

(101 citation statements)

References 8 publications

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“…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].…”

Section: Why Steroids?mentioning

confidence: 99%

The Steroid Controversy: Where Are We?

Keller

Brigger

2013

ORL

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Dexamethasone is widely administered to children during elective tonsillectomy to reduce the rate of postoperative nausea and vomiting, as well as decrease postoperative use of pain medications. Over the past two decades, there has been a wealth of literature advocating the practice that has led to endorsement by a variety of anesthesia and otolaryngology professional associations. However, the publication of a trial that was halted due to a potential dose-dependent association between postoperative hemorrhage and dexamethasone raised significant scrutiny regarding the practice in 2008. As a result, significant re-evaluation of existing data as well as the development and execution of additional trials have been pursued in recent years. Ultimately, the body of evidence that currently exists appears to support the concept that a single dose of perioperative dexamethasone is not associated with undue risk. A decision to withdraw dexamethasone from use in pediatric tonsillectomy needs to be weighed against the potential of causing increased postoperative nausea, vomiting, pain, and resultant hospital readmission. At this point, surgeons and anesthesiologists should feel comfortable giving perioperative dexamethasone but must remain vigilant for bleeding complications.

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Section: Why Steroids?mentioning

confidence: 99%

The Steroid Controversy: Where Are We?

Keller

Brigger

2013

ORL

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“…Previous studies investigating the effect of intravenously administered DX on nausea and vomiting following tonsillectomy have found promising results 2,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] In these studies, DX was most commonly administered as a single intravenous dose before tonsil dissection. In these studies, administered doses were 4 32 or 50 mg 17 was injected with the additional goal of reducing post-tonsillectomy pain 6, 7, 9, 10, 12, 14-17, 19, 20, 22, 24, 25, 35-38 .…”

Section: Discussionmentioning

confidence: 99%

The effect of dexamethasone on post-tonsillectomy nausea, vomiting and bleeding

Windfuhr¹,

Chen²,

Propst³

et al. 2011

Braz. j. otorhinolaryngol. (Impr.)

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It has been stated, that the administration of Dexamethasone has an impact on the morbidity following tonsillectomy.Objective: To re-calculate the blood values for Dexamethasone when given as fixed doses and to evaluate the effect of Dexamethasone on post-operative nausea, vomiting and bleeding rates following tonsillectomy. Materials and methods:The charts of 272 children (2-15 years) who had undergone tonsillectomy were analyzed. The rates of post-operative nausea, vomiting and bleeding in relation to Dexamethasone were calculated-in general and different doses (0 mg/kg, <0.15 mg/kg, >0.15 mg/kg). Study design:Retrospective cohort study.Results: Dexamethasone was administered in 121 children (43.7%) according to the preference of the anesthesist (mean dose: 0.2 +/-0.12 mg/kg; range: 0.04 -0.62 mg/kg). There was no significant difference in nausea and vomiting (p=0.953) or bleeding (p=0.827) across groups receiving or not receiving Dexamethasone. Stratification into three different groups of Dexamethasone concentration also did not identify a dose-related risk of postoperative nausea or vomiting (p=0.98) or bleeding (p=0.71). Conclusion:At least under common non-controlled conditions in the clinic, Dexamethasone does not appear to have an effect on nausea or vomiting or bleeding following tonsillectomy. Braz J Otorhinolaryngol. 2011;77(3):373-9. ORIGINAL ARTICLE BJORL

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“…IV administration of dexamethasone before electrocautery tonsilloadenectomy reduces the incidence of postoperative nausea and vomiting while increasing the quality of oral intake (18). Though it reduces the incidence of postoperative vomiting and surgery related side effects, such as delayed wound healing and increased incidence of wound infection, cautious use of dexamethasone in surgical patients is recommended (2,8,(19)(20)(21). Dexamethasone doses used for antiemesis varies between 8-10 mg and 1mg kg -1 (22,23).…”

Section: R Re Es Su Ul Lt Ts Smentioning

confidence: 99%

“…Though it reduces the incidence of postoperative vomiting and surgery related side effects, such as delayed wound healing and increased incidence of wound infection, cautious use of dexamethasone in surgical patients is recommended (2,8,(19)(20)(21). Dexamethasone doses used for antiemesis varies between 8-10 mg and 1mg kg -1 (22,23). To achieve the best antiemesis with the fewest side effects, Liu et al compared dexamethasone doses of 10 mg, 5 mg, 2,5 mg, and 1,25 mg with placebo in patients undergoing general anesthesia for major gynecological surgery, and they found 2,5 mg to be the minimum effective dose without discernible side effects (6).…”

Section: R Re Es Su Ul Lt Ts Smentioning

confidence: 99%

Minimum Effective Dose of Dexamethasone for Preventing Nausea and Vomiting After Adenotonsillectomy

Çeliker¹

2003

Journal of Ankara Medical School

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Ondansetron and dexamethasone have been observed to decrease the incidence of vomiting in children after general anesthesia, and low dose ondansetron plus dexamethasone is a more effective prophylactic antiemetic combination than high dose ondansetron (150 µg kg -1 ) in children, and it is known that each episode of in hospital vomiting prolongs discharge by 13 ± 2 min (1,2). Vomiting is a common unpleasant sequalea to surgery and anesthesia may result in

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Dexamethasone in adenotonsillectomy

Cited by 90 publications

References 8 publications

The Steroid Controversy: Where Are We?

The Steroid Controversy: Where Are We?

The effect of dexamethasone on post-tonsillectomy nausea, vomiting and bleeding

Minimum Effective Dose of Dexamethasone for Preventing Nausea and Vomiting After Adenotonsillectomy

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