Perioperative Steroids in Tonsillectomy Using Electrocautery and Sharp Dissection Techniques

Hanasono, Matthew M.; Lalakea, M. Lauren; Mikulec, Anthony A.; Shepard, Kimberly; Wellis, Vinit; Messner, Anna H.

doi:10.1001/archotol.130.8.917

Cited by 70 publications

(83 citation statements)

References 17 publications

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“…The existing literature consistently reports that the intracapsular (partial) techniques result in less postoperative pain, however, the degree of lessened pain continues to be much debated [24][25][26]. In addition; there is a small risk of tonsil regrowth and the necessity for an additional procedure with the intracapsular techniques.…”

Section: Discussionmentioning

confidence: 99%

Intra-Capsular Tonsillotomy by Ultrasonic Method

Khalaf¹,

Abdullah²,

Taher³

et al. 2017

JOENTR

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This descriptive prospective study, (non -controlled clinical trial) was conducted during period of February 2016 to February 2017 in AL-Jadryia private hospital total of 80 patients age range (8-64 years old) Gender distribution was 55% male, 45 % female. The patients where compelling from Tonsil hyperplasia, Chronic tonsillitis, Recurrent acute tonsillitis not responding to medical treatment. Surgical Ultrasound (Intra-capsular tonsillotomy) technique was done to them under L.A

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Section: Discussionmentioning

confidence: 99%

Intra-Capsular Tonsillotomy by Ultrasonic Method

Khalaf¹,

Abdullah²,

Taher³

et al. 2017

JOENTR

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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%

“…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 . Unfortunately, there is great variability across studies, making it difficult to draw any conclusions.…”

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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“…Indeed, dexamethasone has become standard care for tonsillectomy patients in many institutions around the world. For a long time, dose responsiveness of dexamethasone for the prevention of PONV in paediatric tonsillectomy has remained unknown, although variable doses up to 1 mg · kg -1 and fixed doses up to 50 mg have been tested [24,25,26,27]. …”

Section: Dexamethasonementioning

confidence: 99%

How to Make Tonsillectomy a Safer Procedure: The Anaesthetist's View

Czarnetzki

Tramèr

2013

ORL

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Anaesthetists use specific drugs peri-operatively to try to decrease the incidence and severity of postoperative pain and of postoperative nausea and vomiting. These drugs are usually administered pre-operatively with the premedication, or intra-operatively when the patient is still anaesthetised. The aim of this approach is to prevent the occurrence of intolerable pain or to avoid any nausea or vomiting symptoms which may be clearly unpleasant for the patient and which interfere with the patient's well-being, recovery and satisfaction. However, since most of these drugs are given prophylactically, and since not all patients will actually be suffering from intolerable pain or severe nausea and vomiting symptoms postoperatively, many patients will receive these drugs unnecessarily. Thus, for the individual patient, the risk of suffering from drug-related adverse reactions without profiting from any benefit may be relevant. Perhaps a ‘wait-and-see' approach should be considered; especially non-steroidal anti-inflammatory drugs or dexamethasone should not be given pre-operatively to all patients but should be provided exclusively to those in whom alternative analgesics (for instance, paracetamol combined with a weak opioid) or alternative anti-emetics (for instance, a setron or droperidol) have failed or are associated with unacceptable adverse effects. There is no evidence that prophylactic administration of an analgesic or an anti-emetic is more efficacious than the therapeutic administration. An interesting alternative to achieve satisfactory posttonsillectomy analgesia may be with local anaesthesia swabs that are applied onto the wound.

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Perioperative Steroids in Tonsillectomy Using Electrocautery and Sharp Dissection Techniques

Cited by 70 publications

References 17 publications

Intra-Capsular Tonsillotomy by Ultrasonic Method

Intra-Capsular Tonsillotomy by Ultrasonic Method

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

How to Make Tonsillectomy a Safer Procedure: The Anaesthetist's View

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