Comparison of local and intravenous dexamethasone for postoperative pain and
recovery after tonsillectomy.
Author(s): Gao W(1), Zhang QR(1), Jiang L(1), Geng JY(2).
Affiliation(s): Author information:
(1)Department of Anesthesiology, Second Affiliated Hospital, Harbin Medical
University, Nangang District of Harbin, Harbin, China. (2)Department of
Anesthesiology, Second Affiliated Hospital, Harbin Medical University, Nangang
District of Harbin, Harbin, China gaowei20055@126.com gengjieying1403008@163.com.
Publication date & source: 2015, Otolaryngol Head Neck Surg. , 152(3):530-5
OBJECTIVE: To compare local infiltration of dexamethasone to intravenous
injection for postoperative pain and recovery after tonsillectomy.
STUDY DESIGN: Prospective, randomized study.
SETTING: Second Affiliated Hospital of Harbin Medical University.
SUBJECTS AND METHODS: Children (n=240, American Society of Anesthesiologists
[ASA] classes I-II, aged 5-10 y) scheduled for tonsillectomy were randomly and
equally assigned to 3 groups: DEX-IV, for intravenous injection of dexamethasone
(0.5 mg/kg, maximum dose 24 mg); DEX-INF, given the same amount of dexamethasone
by local infiltration to the upper middle and lower poles of the tonsils; and a
control group not given dexamethasone. Postoperative pain was scored at intervals
from 30 minutes to 24 hours. The time to first administration of analgesic and
average consumption of analgesic, times to first oral water and solid food
intake, and incidence rates of nausea and vomiting were evaluated.
RESULTS: From postoperative 1 to 16 hours, the DEX-INF group had significantly
lower pain scores than did the DEX-IV group, and the time to first analgesic and
average consumption of analgesic were also significantly lower. The times to
first oral water and food intake in the DEX-INF group were significantly shorter
than in the DEX-IV group. The incidence of nausea and vomiting in the DEX-INF
group was higher than that of the DEX-IV group.
CONCLUSION: Local infiltration of dexamethasone was more effective than systemic
administration to decrease pain and time to food intake, but the antiemetic
effect was less.
CLINICAL TRIALS REGISTRATION NUMBER: ChiCTR-TRC-13003535.
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