The Effect of Dexamethasone on Postoperative Vomiting After Tonsillectomy

Aouad, Marie T.; Siddik, Sahar; Rizk, Laudia B.; Zaytoun, Georges; Baraka, Anis

doi:10.1213/00000539-200103000-00015

Cited by 68 publications

(7 citation statements)

References 29 publications

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“…Additional comorbidities after tonsillectomy include pain and poor oral intake. In addition to having a beneficial effect on PONV, dexamethasone decreases throat pain after tonsillectomy and time to resumption of oral intake 211‐214 …”

Section: Guideline Key Action Statementsmentioning

confidence: 99%

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Mitchell

Archer

Ishman

et al. 2019

Otolaryngol.--head neck surg.

378

470

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Objective. This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children \15 years of age based on the most recent published data. This guideline is intended for all clinicians in any setting who interact with children who may be candidates for tonsillectomy. KAS 14 (Postoperative codeine), and KAS 15a (Outcome assessment for bleeding). (6) Addition of an algorithm outlining KASs. (7) Enhanced emphasis on patient and/or caregiver education and shared decision making.

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Section: Guideline Key Action Statementsmentioning

confidence: 99%

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Mitchell

Archer

Ishman

et al. 2019

Otolaryngol.--head neck surg.

378

470

View full text Add to dashboard Cite

show abstract

“…Additional comorbidities after tonsillectomy include pain, poor oral intake, and changes in voice character. In addition to having a beneficial effect on PONV, dexamethasone also decreases throat pain after tonsillectomy and time to resumption of oral intake, 160 – 162 which may be of particular benefit when electrosurgery is used to remove the tonsils.…”

Section: Guideline Key Action Statementsmentioning

confidence: 99%

Clinical Practice Guideline: Tonsillectomy in Children

Baugh

Archer

Mitchell

et al. 2011

Otolaryngol.--head neck surg.

800

754

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The panel made a strong recommendation that clinicians should administer a single, intraoperative dose of intravenous dexamethasone to children undergoing tonsillectomy. The panel made a strong recommendation against clinicians routinely administering or prescribing perioperative antibiotics to children undergoing tonsillectomy. The panel made recommendations for (1) watchful waiting for recurrent throat infection if there have been fewer than 7 episodes in the past year or fewer than 5 episodes per year in the past 2 years or fewer than 3 episodes per year in the past 3 years; (2) assessing the child with recurrent throat infection who does not meet criteria in statement 2 for modifying factors that may nonetheless favor tonsillectomy, which may include but are not limited to multiple antibiotic allergy/intolerance, periodic fever, aphthous stomatitis, pharyngitis and adenitis, or history of peritonsillar abscess; (3) asking caregivers of children with sleep-disordered breathing and tonsil hypertrophy about comorbid conditions that might improve after tonsillectomy, including growth retardation, poor school performance, enuresis, and behavioral problems; (4) counseling caregivers about tonsillectomy as a means to improve health in children with abnormal polysomnography who also have tonsil hypertrophy and sleep-disordered breathing; (5) counseling caregivers that sleep-disordered breathing may persist or recur after tonsillectomy and may require further management; (6) advocating for pain management after tonsillectomy and educating caregivers about the importance of managing and reassessing pain; and (7) clinicians who perform tonsillectomy should determine their rate of primary and secondary posttonsillectomy hemorrhage at least annually. The panel offered options to recommend tonsillectomy for recurrent throat infection with a frequency of at least 7 episodes in the past year or at least 5 episodes per year for 2 years or at least 3 episodes per year for 3 years with documentation in the medical record for each episode of sore throat and 1 or more of the following: temperature >38.3°C, cervical adenopathy, tonsillar exudate, or positive test for group A β-hemolytic streptococcus.

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“…IV dexamethasone 4 mg was selected as the routine antiemetic prophylaxis. It has been found to be a costeffective prophylactic antiemetic, with a number needed to treat of 4.7 for PONV (26)(27)(28). Despite this antiemetic prophylaxis, the overall incidence of PONV in our sham group was reported at 64.9%.…”

Section: Discussionmentioning

confidence: 80%

Effectiveness of P6 acupoint electrical stimulation in preventing postoperativenausea and vomiting following laparoscopic surgery

Yeoh¹,

Tang²,

Manap³

et al. 2016

Turk J Med Sci

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Background/aim: The effects of pericardium 6 (P6) electrical stimulation in patients at risk of postoperative nausea and vomiting (PONV) following laparoscopic surgery were evaluated. Materials and methods:Eighty patients for laparoscopic surgery with at least one of the determined risks (nonsmoker, female, previous PONV/motion sickness, or postoperative opioid use) were randomized into either an active or sham group. At the end of surgery, Reletex electrical acustimulation was placed at the P6 acupoint. The active group had grade 3 strength and the sham group had inactivated electrodes covered by silicone. It was worn for 24 h following surgery. PONV scores were recorded. Results:The active group had significantly shorter durations of surgery and lower PONV incidence over 24 h (35.1% versus 64.9%, P = 0.024) and this was attributed to the lower incidence of nausea (31.4% versus 68.6%, P = 0.006). The overall incidence of vomiting was not significantly different between the groups, but it was higher in the sham group of patients with PONV risk score 3 (23.9%, P = 0.049). Conclusion:In patients at high risk for PONV, P6 acupoint electrical stimulation lowers the PONV incidence by reducing the nausea component. However, this reduction in nausea is not related to increasing PONV risk scores.

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The Effect of Dexamethasone on Postoperative Vomiting After Tonsillectomy

Cited by 68 publications

References 29 publications

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Clinical Practice Guideline: Tonsillectomy in Children (Update)

Clinical Practice Guideline: Tonsillectomy in Children

Effectiveness of P6 acupoint electrical stimulation in preventing postoperativenausea and vomiting following laparoscopic surgery

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