A meta-analysis of dexamethasone use with tonsillectomy

Andrew C. Goldman, Satish Govindaraj, Richard M. Rosenfeld

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

OBJECTIVE: To determine the quantitative impact of intravenous dexamethasone on recovery after tonsillectomy using established principles for metaanalysis. STUDY DESIGN/SETTING: Double-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. RESULTS: Pooled analysis using a random effects model revealed a 27% decrease (P < 0.00001) in postoperative emesis attributable to dexamethasone (95% Cl, 12% to 42%). Dexamethosone in-Creased the tolerance of a soft/regular diet at 24 hours by 22% (P < 0.001), but studies were her' erogenous with low precision (95% Cl, 1% to 44%). CONCLUSION: To 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. SIGNIFICANCE: Perioperative dexamethasone administration had a positive impact on recovery from tonsillectomy.

Original languageEnglish
Pages (from-to)682-686
Number of pages5
JournalOtolaryngology - Head and Neck Surgery
Volume123
Issue number6
DOIs
StatePublished - 2000

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