Dexamethasone Use During Tonsillectomy Increases Risk for Postoperative Bleeding

The reduction in vomiting does not justify the increased risk for postoperative hemorrhage.

Dexamethasone is used during tonsillectomy to prevent postoperative nausea and vomiting, but well-designed studies to evaluate its efficacy are lacking. Investigators randomized 215 children (age range, 2–17 years) at a hospital in Switzerland to receive placebo or one of three doses of dexamethasone (0.05, 0.15, or 0.50 mg/kg) intravenously after induction of anesthesia during elective tonsillectomy.

Compared with placebo, use of dexamethasone significantly and dose-dependently reduced the incidence of nausea and vomiting after surgery. Use of dexamethasone also significantly reduced the need for ibuprofen postoperatively. However, the risk for postoperative bleeding was higher with dexamethasone and increased significantly with increasing …

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)