Volume 26, Issue 3 (Avicenna Journal of Clinical Medicine-Autumn 2019)                   Avicenna J Clin Med 2019, 26(3): 131-136 | Back to browse issues page


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1- , hashemian@umsha.ac.ir
Abstract:   (10416 Views)
Background and Objective: 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.
Materials and Methods: 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).
Results: 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.
Conclusion: 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.
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Type of Study: Original | Subject: Otorhinolaryngology

References
1. Amani S, Rastiboroujeni M, Abedinzade M. Effects of local injection of bupivacaine and dexamethasone on postoperative pain of adenotonsillectomy. J Shahrekord Univ Med Sci. 2006;8(1):76-81. [Persian]
2. Aouad MT, Siddik SS, Rizk LB, Zaytoun GM, Baraka AS. The effect of dexamethasone on postoperative vomiting after tonsillectomy. Anesth Analg. 2001;92(3):636-40. PMID: 11226091 DOI: 10.1097/00000539-200103000-00015
3. Leong SC, Karkos PD, Papouliakos SM, Apostolidou MT. Unusual complications of tonsillectomy: a systematic review. Am J Otolaryngol. 2007;28(6):419-22. PMID: 17980776 DOI: 10.1016/j.amjoto.2006.10.016
4. Karaaslan K, Yilmaz F, Gulcu N, Sarpkaya A, Colak C, Kocoglu H. The effects of Levobupivacaine Versus Levobupivacaine plus Magnesium infiltration on postoperative analgesia and Laryngospasm in pediatric Tonsillectomy Patients. Int J Pediatr Otorhinolaryngol. 2008;72(5):675-81. PMID: 18325601 DOI: 10.1016/j.ijporl.2008.01.029
5. Giannoni C, White S, Enneking FK. Does dexamethasone with preemptive analgesia improve pediatric Tonsillectony pain? Otolaryngol Head Neck Surg. 2002;126(3):307-15. PMID: 11956540 DOI: 10.1067/mhn.2002.122700
6. Sampaio AL, Pinheiro TG, Furtado PL, Araújo MF, Olivieira CA. Evaluation of early postoperative morbidity in pediatric tonsillectomy with the use of sucralfate. Int J Pediatr Otorhinolaryngol. 2007;71(4):645-51. PMID: 17275926 DOI: 10.1016/j.ijporl.2006.12.016
7. Ugur MB, Yilmaz M, Altunkaya H, Cinar F, Ozer Y, Beder L. Effects of intramuscular and peritonsillar injection of tramadol before tonsillectomy: a double blind, randomized, placebo- controlled clinical trial. Int J Pediatr Otorhinolaryngol. 2008;72(2):241-8. PMID: 18079005 DOI: 10.1016/j.ijporl.2007.11.002
8. Afman CE, Welge JA, Steward DL. Steroids for post-tonsillectomy pain reduction: Meta-analysis of randomized controlled trials. Otolaryngol Head Neck Surg. 2006;134(2):181-6. PMID: 16455362 DOI:10.1016/j.otohns.2005.11.010
9. Montazeri K, Okhovat A, Honarmand A, Safavi MR, Ashrafy L. Pre-incisional infiltration of tonsils with dexamethasone dose not reduce posttonsillectomy vomiting and pain in children. Saudi J Anaesth. 2009;3(2):53-6. PMID: 20532103 DOI: 10.4103/1658-354X.57874
10. Abbasivash R, Mahoori AR, Ahmadi Roozbehani N, Ebadi S, Saane SH. Investigating the effects of interavenous dexametasone reduction in post tonsillectomy and adenotoncilectomy sore throat and vomiting. J Urmia Univ Med Sci. 2015;26(1):56-63. [Persian]
11. Gao W, Zhang QR, Jiang L, Geng JY. Comparison of local and intravenousdexamethasone for postoperative pain and recovery after tonsillectomy. Otolaryngol Head Neck Surg. 2015;152(3):530-5. PMID: 25605698 DOI: 10.1177/0194599814567856
12. Najeeb T, Bangash K, Nasarullah M, Husain A. Role of preoperative dexamethasone in reduction of post tonsillectomy pain. J Islamabad Med Dent Coll. 2016;5(2):67-70.

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