Determination of optimum dosage of intraoperative single dose dexamethasone in pediatric tonsillectomy and adenotonsillectomy.

OBJECTIVE

Our objective is to determine the optimum dosage of intraoperative single dose dexamethasone and its effect upon postoperative morbidity in pediatric tonsillectomy and adenotonsillectomy patients.

STUDY DESIGN AND METHODS

Totally 150 pediatric patients whom underwent adenotonsillectomy or tonsillectomy surgery are offered to participate in this study at otorhinolaryngology clinic between 2002 and 2003. 150 patients are divided into three randomized groups, each composed of fifty patients. Anesthesia protocol is standardized in each group and 0.2 mg/kg intraoperative dexamethasone is given to first group, 0.7 mg/kg (maximum dose 25 mg) intraoperative dexamethasone is given to second group and third group is accepted as control group without giving any intravenous dexamethasone. Each group is compared for postoperative nausea, vomiting and tolerability to take oral foods within first 24h with the same questionnaire.

RESULTS

There is significantly higher ratio of postoperative nausea and vomiting within first 24h in group III (80%) when compared with group I (8%) (p: 0.001; p<0.01) and group II (4%) (p: 0.001; p<0.01). Also there is significantly higher ratio of patient's tolerability to take oral semisolid/solid foods within postoperative first 24h in group II (94%) when compared with group I (58%) (p: 0.001; p<0.01) and group III (12%) (p: 0.001; p<0.01). We didn't encounter any side effect of dexamethasone in group I and II.

CONCLUSIONS

We thought that 0.7 mg/kg dosage of IV dexamethasone is much a preferable choice depending of its effectiveness on decreasing postoperative morbidity rather than 0.2 mg/kg dosage and beside to this advantage we didn't encounter any side effects.