Minimum effective dose of dexamethasone after tonsillectomy

Background: The minimum effective dose of dexamethasone in conjunction with 50 mug(.)kg(-1) ondansetron was evaluated in the treatment for vomiting after elective tonsillectomy or adenotonsillectomy. Methods: A total of 102 healthy children between 2 and 12 years of age participated in this prospective, randomized, double-blind study. A single intravenous (i.v.) dose of dexamethasone (50, 100, 150 mug(.)kg(-1), maximum dose 8 mg) with ondansetron (50 mug(.)kg(-1)) was administered just before the end of surgery. Equal volumes of normal saline were given to the control group. General anaesthesia was induced and maintained by inhalation of N2O/O-2 and sevoflurane. All other preoperative and postoperative medications (including a supplementary dose of antiemetics if necessary), anaesthesia and surgical techniques were standardized. Results: No significant differences were observed between groups in postoperative vomiting on the day of surgery and the next day, or in the need for postoperative pain medication and supplementary doses of antiemetics (P > 0.05). Conclusions: These results indicate that surgical technique and anaesthetic management used in this study could be the cause of the lower incidence of nausea and vomiting. Assessment of nausea and vomiting in a prospective study with larger groups of patients may reflect different results.