Preemptive Dexamethasone Reduces Pediatric Post-Tonsillectomy Pain: A Triple-Blind Randomized Clinical Trial

Adenotonsillectomy is one of the most commonly performed surgical procedures in children. Although this surgery is technically easy, it can run a high risk of serious complications, such as laryngeal spasm, laryngitis, bleeding, pain, and nausea. The present study  aimed to assess the effect of preemptive dexamethasone on pediatric post tonsillectomy pain.

This triple-blinded clinical trial study involved a total number of  70 children within the age range of  3-15 years. They were candidates for adenotonsillectomy and were randomly assigned to two groups. One hour before the surgery, one group received intravenous dexamethasone (0.1 mg/kg) and the other group received distilled water intravenously. Patients' pain at 1, 4, 10, and 24 hours after the surgery, initiation of soft-diet feeding and the prevalence of nausea and vomiting were evaluated in both groups. Data were analyzed in SPSS software (version 16).

The total number of patients was 70 (35 in each group). Both groups were homogenous in terms of age and gender. In the intervention group, the mean score of pain in the first and fourth hours and the mean initiation time of soft- diet feeding were significantly lower, as compared to those of the control group (P <0.05). The mean score of the pain in the intervention group at hours 1,4,10, and 24 after tonsillectomy were obtained at 8.40, 5.74, 4.28, and 2.28, respectively. On the other hand, in the control group, the above mentioned mean scores were measured at 9.40, 6.80, 4.51, and 2.7 respectively (P<0.05). Nonetheless, it is noteworthy that no significant difference was observed between the two groups regarding the incidence of nausea and vomiting.

As evidenced by the obtained results, preemptive dexamethasone reduces the post tonsillectomy pain in the first four hours after pediatric adenotonsillectomy. Moreover, it was revealed that it accelerates the initiation of soft-diet feeding without exerting any effect on nausea and vomiting.