• A C Goldman, S Govindaraj, and R M Rosenfeld.
• Department of Otolaryngology, SUNY-Health Science Center, Brooklyn, New York, USA.
• Otolaryngol Head Neck Surg. 2000 Dec 1;123(6):682-6.

ObjectiveTo determine the quantitative impact of intravenous dexamethasone on recovery after tonsillectomy using established principles for meta-analysis.Study Design/SettingDouble-blind randomized-control trials in which subjects were treated identically except for the presence or absence of perioperative intravenous dexamethasone. Six articles met inclusion criteria. Two investigators extracted data regarding postoperative emesis and return to a soft/regular diet.ResultsPooled analysis using a random effects model revealed a 27% decrease (P<0.00001) in postoperative emesis attributable to dexamethasone (95% CI, 12% to 42%). Dexamethasone increased the tolerance of a soft/regular diet at 24 hours by 22% (P< 0.001), but studies were heterogenous with low precision (95% CI, 1% to 44%).ConclusionTo prevent emesis in 1 child after tonsillectomy, approximately 4 children must receive perioperative dexamethasone. An additional benefit is earlier tolerance of a soft/regular diet, but low precision and heterogeneity among studies preclude definitive conclusions.SignificancePerioperative dexamethasone administration had a positive impact on recovery from tonsillectomy.

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