Does Perioperative Dexamethasone Increase Risk for Bleeding Following Tonsillectomy?

In a randomized clinical trial, perioperative dexamethasone did not increase clinically significant postoperative bleeding, but an increase in parent-reported or subjective bleeding could not be ruled out.

Perioperative corticosteroids are often given to children undergoing adenotonsillectomy to manage postoperative nausea and vomiting (PONV). However, a randomized, controlled trial of the dose response to perioperative dexamethasone was stopped because a dexamethasone dose of 0.5 mg/kg increased the risk for postoperative hemorrhage, a major complication of adenotonsillectomy and source of morbidity (JW Pediatr Adolesc Med Jan 14 2009). Now, a different group of researchers has examined the safety profile of dexamethasone in 314 children undergoing tonsillectomy at two tertiary centers. The children were randomized to receive dexamethasone (0.5 mg/kg or a maximum dose of 20 mg) or a saline placebo on the day of surgery. Mean age (6 years), d…

Reviewing Author

Louis M. Bell, MD

Disclosures

Grant/Research SupportNIH Institutional Clinical and Translational Science Award; Agency for Healthcare Research and Quality National Center for Pediatric Practice Based Research Learning; Patient-Centered Outcomes Research Institute

Editorial BoardsCurrent Problems in Pediatric Adolescent Healthcare

Leadership Positions in Professional Societies College of Physicians of Philadelphia (Board of Trustees)

Louis M. Bell, MD

Disclosures

Editorial BoardsCurrent Problems in Pediatric Adolescent Healthcare

Leadership Positions in Professional Societies College of Physicians of Philadelphia (Board of Trustees)