Effects of Perioperative Steroids in Tonsillectomy Using Sharp Dissection Technique in Adults on First Postoperative Day

Objective; To determine the effects of periperative dexamethasone sodium phosphate administration on post tonsillectomy morbidity for sharp dissection technique. Study Design: Randomized control study Place and Duration of the Study: The Study was conducted at the ENT Department, Hayatabad Medical Complex (HMC) and Pakistan Institute of Medical Sciences, Islamabad from March 2009 to March 2010. Materials and Methods: A total 108 patients included in the study were randomly assigned to receive either dexamethasone sodium phosphate (1 mg/kg) or placebo. Post tonsillectomy pain, oral intake and postoperative vomiting were measured on post operative day (POD) 1 . Results: A total of 54 patients received preoperative steroids and 54 patients received placebo undergoing tonsillectomy by sharp dissection technique. On POD 1 pain scores (p=0.016) were significantly lower in subjects receiving steroids than in those receiving placebo. Postoperative vomiting was reduced from 63 % (placebo group) to 25.9 % (steroid group) (p=0.02).Oral intake improved from 22.2% of normal diet (placebo group) to 31.5% (steroid group) (p=0004).when two groups were compared postoperative pain scores were significantly lower in the steroid group than in the other group. Conclusion: Perioperative dexamethasone reduces post tonsillectomy morbidity in the adult patients in the early postoperative period after cold dissection tonsillectomy.