The Effect of Steroid Therapy on Recovery From Tonsillectomy in Children

Catlin, Francis I.; Grimes, William J.

doi:10.1001/archotol.1991.01870180085016

Cited by 115 publications

(127 citation statements)

References 9 publications

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“…[8][9][10] These studies included a limited number of patients and anesthetic and antiemetic protocols were not standardized. Postoperative nausea and vomiting are a multifactorial problem and several anesthetic and nonanesthetic factors must be controlled to obtain meaningful results.…”

Section: Figure 1 Median Children's Hospital Eastern Ontario Painmentioning

confidence: 99%

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Elhakim

Rashed

et al. 2003

Can J Anesth/J Can Anesth

148

121

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P Pu ur rp po os se e: : Previous studies on dexamethasone's antiemetic and analgesic potential in children undergoing tonsillectomy have produced conflicting results. The aim of this study was to evaluate the effects of a single dose of dexamethasone on the incidence and severity of postoperative vomiting and pain in children undergoing electrocautery tonsillectomy under standardized general anesthesia. M Me et th ho od ds s: :In a double-blinded study, 120 patients were randomly allocated to receive either dexamethasone 0.5 mg·kg -1 (maximum dose 8 mg) iv or an equivalent volume of saline preoperatively. The incidence of early and late vomiting, need for rescue antiemetics, time to first oral intake, time to first demand of analgesia and analgesic consumption were compared in both groups. Pain scores used included Children's Hospital Eastern Ontario Pain Scale, "faces", and a 0-10 visual analogue pain scale.R Re es su ul lt ts s: : Compared with placebo, dexamethasone significantly decreased the incidence of early and late vomiting (P < 0.05, P < 0.001 respectively). Fewer patients in the dexamethasone group needed antiemetic rescue (P < 0.01). The time to first oral intake was shorter, and the time to first dose of analgesic was longer in the dexamethasone group (P < 0.01). Pain scores 30 min after extubation were lower (P < 0.05) in the dexamethasone group. At 12 and 24 hr postoperative swallowing was still significantly less painful in the dexamethasone group than in the control group (P < 0.01).C Co on nc cl lu us si io on n: : Preoperative dexamethasone 0.5 mg·kg -1 iv reduced both postoperative vomiting and pain in children after electrocautery tonsillectomy. ONSILLECTOMY is one of the most frequently performed ambulatory surgical procedures in children and is associated with an incidence of postoperative vomiting ranging between 40% and 73%. 1-3 The introduction of an electrodissection surgical technique has virtually eliminated immediate postoperative hemorrhage. However, it may cause more pain, discomfort Résultats : Comparée au placebo, la dexaméthasone a significativement réduit l'incidence de vomissements précoces et tardifs (P < 0,05, P < 0,001 respectivement). Peu de patients ayant reçu la dexaméthasone ont eu besoin d'antiémétique de secours (P < 0,01

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Section: Figure 1 Median Children's Hospital Eastern Ontario Painmentioning

confidence: 99%

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Elhakim

Rashed

et al. 2003

Can J Anesth/J Can Anesth

148

121

View full text Add to dashboard Cite

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“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Guerra

García

Pilan

et al. 2008

Rev. Bras. Otorrinolaringol.

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Tonsi llectomy with or without adenoidectomy still is one of the most commonly performed surgical procedures in the world, mostly in the pediatric population. Aim: to study the impact of amoxicillin for 7 days in post-adenotonsillectomy recovery, comparing results with a control group. Study type: prospective, randomized, controlled study with 120 patients. Patients and Methods: the patients were randomized according to surgery time to receive 7 days of amoxicillin associated with pain killers, or analgesic alone. During the first week of postoperative, we assessed the level of pain, oral intake acceptance, nausea and vomits, fever and return to daily activities. Results: It was only in the fourth postoperative day that the group receiving antibiotic agents showed a statistically significant difference as far as pain is concerned. There was no difference between the two groups for other data analyzed. Conclusion: considering the results from our study and reviewing the literature on the use of antibiotic agents, we agree that there is no improvement in patient recovery after adenotonsillectomy with the use of amoxicillin for 7 days in the postoperative.

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“…Dexamethasone, a corticosteroid with strong antiinflammatory effects, provides postoperative analgesia [35], prevents nausea and vomiting in patients undergoing chemotherapy [36], and reduces postoperative nausea and vomiting (PONV) [37]. Dexamethasone may inhibit the synthesis of prostaglandin and various other inflammatory mediators, which are known to act on chemoreceptor trigger zone and cause emesis [38]. Previous studies suggested that decreased serotonin release in the central nervous system and changes in the permeability of the blood cerebrospinal fluid barrier to serum proteins [39] may also play a role in the antiemetic effects of corticosteroids.…”

Section: Application Of Steroids In Ponvmentioning

confidence: 99%

Applications of Steroid in Clinical Practice: A Review

Shaikh

Verma²,

Yadav³

et al. 2012

ISRN Anesthesiology

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Steroids are perhaps one of the most widely used group of drugs in present day anaesthetic practice, sometimes with indication and sometimes without indications. Because of their diverse effects on various systems of the body, there has been renewed interest in the use of steroids in modern day anaesthetic practice. This paper focuses on the synthesis and functions of steroids and risks associated with their supplementation. This paper also highlights the recent trends, relevance, and consensus issues on the use of steroids as adjunct pharmacological agents in relation to anaesthetic practice and intensive care, along with emphasis on important clinical aspects of perioperative usefulness and supplementation.

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The Effect of Steroid Therapy on Recovery From Tonsillectomy in Children

Cited by 115 publications

References 9 publications

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy

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

Applications of Steroid in Clinical Practice: A Review

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