Evaluating the Effects of Oral Prednisolone on Recovery After Tonsillectomy: A Prospective, Double‐Blind, Randomized Trial

Abstract

Objectives:To investigate the role of a 7-day course of oral prednisolone on recovery from tonsillectomy. Study Design: Double-blind, randomized, placebo-controlled trial of 50 consecutive patients, aged 5 years and older, who had no previous or known contraindications to steroid therapy. Method: The patients were randomized at the time of surgery to either a 7-day course of daily placebo or prednisolone (dosage: 10 mg per day in patients aged 5-11 y, 0.5 mg/kg in those aged 12 and older). Age, sex, weight, diagnosis, tonsil size (in cm 2 ), additional adenoidectomy, performing surgeon, method of dissection, length of procedure, total blood loss, intraoperative fluid requirement, and length of hospitalization were documented for each patient. During the first postoperative day, morning pain score, paracetamol use, oral fluid intake, temperature, presence of nausea and vomiting, level of activity (low, moderate, or normal), and type of diet (liquid, soft, or normal) were recorded. Results: The steroid group consisted of a greater number of diathermy dissection cases and had significantly less intraoperative blood loss (P value ‫؍‬ .022 and .017, respectively). On postoperative days 4 to 7, the steroid group experienced less nausea and vomiting (P value ‫؍‬ .01, .04, .04, and .04, respectively). Paracetamol use was less in the steroid group on days 2, 7, and 8 (P value ‫؍‬ .03, .02, and .02, respectively). There was no difference between the two groups for the other data measured. Conclusion: A 7-day course of corticosteroids may play a limited role in patients' recovery from tonsillectomy.

A survey of the administration of prednisolone versus ibuprofen analgesic protocols after ambulatory tonsillectomy

“…Prednisolone was replaced by ibuprofen in the second part of the study. One reason was the weak impact of prednisolone on pain scores and PONV after tonsillectomy [4,5]. Indeed, one study found comparable pain scores between placebo and prednisolone administered during 7 days after tonsillectomy, with only a reduction in nausea after POD4 [4].…”

Avaliação da antibioticoterapia na morbidade pós-adenotonsilectomia: estudo prospectivo randomizado

“…Pain in the post-op is worse during the first five days, and although many treatment options have been studied, none was consistently successful [9][10][11][12][13][14] . In 2005, Collin et al 1 carried out a meta-analysis looking at randomized trials published in the literature and could not find statistically significant differences in post-op pain levels of adenotonsillectomy patients treated or not with antibiotics.…”

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

“…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 .…”