• M M April, N D Callan, D M Nowak, and M A Hausdorff.
• Department of Surgery, State University of New York at Stony Brook, USA.
• Arch Otolaryngol. 1996 Feb 1;122(2):117-20.

ObjectiveTo determine whether the intravenous administration of dexamethasone sodium phosphate before tonsillectomy and adenoidectomy can reduce the morbidity from, and increase the safety of, this procedure.DesignProspective, randomized, double-blind, placebo-controlled clinical trial.SettingA university medical center, caring for both ambulatory and hospitalized children.PatientsEighty children aged 3 to 15 years undergoing tonsillectomy and adenoidectomy for either chronic tonsillitis or adenotonsillar hypertrophy (obstructive sleep apnea and/or upper airway obstruction).InterventionsForty-one children received intravenous dexamethasone sodium phosphate (1 mg/kg up to 16 mg) and 39 received placebo before undergoing an electrocautery dissection tonsillectomy and adenoidectomy.Main Outcome MeasuresPostoperative oral intake, pain, vomiting, temperature, and complications.ResultsPatients who received intravenous dexamethasone had significantly less trismus, vomiting, and elevations of temperature 6 hours after surgery and more oral intake (liquids and soft solids) at 24 hours. Three children, all of whom were in the placebo group, had emergency department visits for pain and dehydration. Each group had one child who had a secondary hemorrhage (no surgery needed), one child who had pneumonia, and one child who had night terrors.ConclusionsTreatment with intravenous dexamethasone before electrocautery tonsillectomy and adenoidectomy is safe, increases early postoperative oral intake, and decreases morbidity.

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