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Use of intravenous steroids at induction of anaesthesia for adult tonsillectomy to reduce post‐operative nausea and vomiting and pain: a double‐blind randomized controlled trial
Author(s) -
McKean S.,
Kochilas X.,
Kelleher R.,
Dockery M.
Publication year - 2006
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/j.1749-4486.2006.01141.x
Subject(s) - medicine , tonsillectomy , nausea , vomiting , anesthesia , dexamethasone , placebo , postoperative nausea and vomiting , general anaesthesia , randomized controlled trial , adverse effect , visual analogue scale , surgery , alternative medicine , pathology
Objective: To assess the effectiveness of intravenous steroids at induction of anaesthetic to reduce post‐operative nausea and vomiting and pain after adult tonsillectomy. Design: Prospective, double‐blind, randomized, placebo controlled trial, with ethical approval, following Consolidated Standards of Reporting Trials guidelines. Setting: District General Hospital in Scotland, UK. Participants: Seventy‐two adults between 16 and 70 years, American Association of Anaethetists (ASA) 1, listed for elective tonsillectomy. Intervention: Single dose of either 10 mg of dexamethasone or 2 mL of saline after induction with a consistent anaesthetic technique. Main outcome measures: Patients filled in a visual analogue scale relating to pain and post‐operative nausea and vomiting for the day of operation and 7 days after operation. The time to first ingestion of food and drink after operation was also noted. Results: Data completion rate of 64% (46 of 72 patients enrolled). Statistically significant relative decrease (62% P = 0.001) in the incidence of post‐operative nausea and vomiting was seen in those treated with dexamethasone. Statistically significant relative decrease (23% P = 0.016) in post‐operative pain scores for the day of operation was seen in those treated with dexamethasone. Significant decrease (17.5%, P < 0.001) in mean pain score for seven post‐operative days was seen in those treated with dexamethasone. No adverse effects were seen. Conclusions: Dexamethasone given as a single dose of 10 mg at induction of anaesthesia for adult tonsillectomy is an effective, safe and inexpensive method for reducing morbidity in adult tonsillectomy.