Effect of intraoperative single dose of dexamethasone on posttonsillectomy pain in children: a systematic review and meta-analysis

Abstract

Background Tonsillectomy is one of the commonest operative techniques done universally. In spite of developments in anesthetic and operative procedures, posttonsillectomy pain remains a vital clinical problem. Posttonsillectomy pain is perhaps the consequence of muscle spasm caused by inflammation and irritation of the pharyngeal muscular structure. Postoperatively cases frequently have significant odynophagia, alteration of diet, and reduced activity. The recovery interval of kids frequently continues from 4 to 7 days, whereas adults might continue being symptomatic up to 2 weeks. The odynophagia may be sufficiently severe to control oral intakes, which in occasional cases can lead to dehydration needing admittance for intravenous fluids. Aim This work aimed to evaluate the consequence of intraoperative single dosage of dexamethasone on posttonsillectomy pains in kids and to verify its significance. Patients and methods A systematic review of presently accessible randomized controlled trials via a one-dose, intravenous corticoid throughout pediatric tonsillectomy has been done. Visual analog pain score information was obtained with reviewers blinded to findings. Results Seven randomized trials have been involved in posttonsillectomy pain analysis. A significant decrease in pain as determined by visual analog pain score on the first-day postoperatively was found. Conclusions A single, intraoperative dosage of dexamethasone can decrease posttonsillectomy pain on the first day postoperatively by a factor of 1 on a 10-point pain scale. As the adverse effects and price of dexamethasone dosage seem negligible, considerations of routine usage appear acceptable.