Effect of steroids on posttonsillectomy pain in adults

Objective: To determine whether a single intraoperative dose of intravenous dexamethasone has an effect on pain after tonsillectomy. Design: Double-blinded randomized controlled clinical trial. Subjects: Thirty-four consecutive nonpediatric patients presenting for tonsillectomy. Intervention: Patients scheduled for electrocautery tonsillectomy were randomized to receive either intravenous dexamethasone or placebo during surgery. Pain was measured twice daily for 10 days by means of a visual analog scale. Results: There were no statistically significant differences between the groups, but the dexamethasone group had a trend to report less pain over the first several days. The dexamethasone group received less analgesic in the recovery room, but there were no differences between the groups in the 10 days afterward. Conclusions: There is evidence that a single dose of dexamethasone reduces pain after tonsillectomy to a small degree. A single dose was not associated with adverse effects, so the risk-benefit ratio may be favorable for this practice.