Analgesic efficacy of preoperative single dose intravenous dexamethasone in pediatric tonsillectomies by either sharp snare dissection technique or laser technique: A randomised controlled trial

Abstract

This study was designed to evaluate the postoperative analgesic efficacy of intravenous dexamethasone, and also to determine the postoperative rescue analgesic consumption, morbidity with respect to surgical technique, quality of oral intake, incidence of postoperative nausea and vomiting (PONV), and discharge from hospital. After ethical committee clearance, a prospective randomized double blind study was planned for one year period on 100 pediatric patients, with5-12 years of age, American Society of Anesthesiologists physical class I and II, undergoing elective tonsillectomy with or without adenoidectomy under general anesthesia were included in the study. Patients were randomly allocated into 4 groups and received the study drug intravenously 10 minutes before induction of anesthesia. Group A undergoing sharp snare dissection tonsillectomy received 0.9% normal saline 50ml, group B sharp snare dissection tonsillectomy received dexamethasone 0.15mg/kg diluted in 0.9% normal saline, group C laser tonsillectomy received 0.9% normal saline 50 ml, group D laser tonsillectomy received dexamethasone 0.15mg/kg diluted in 0.9% normal saline.We observed statistically significant difference in mean pain scores (p<0.05) between dexamethasone group (group B and D) and control group (group A and C) measured by KruskalWallis analysis of Variance test with less pain in dexamethasone group.Single dose intravenous administration of dexamethasone (0.15mg/kg) resulted in reduction of post-operative pain, need for rescue analgesics, reduced incidence of PONV, early return to normal diet and discharge from the hospital.