Sharafat Ali Khan, Ihsanullah, Sohail Khan, Muhammad Iqbal, Naveed Khan, Gulshan Hussain, Mahid Iqbal.
Post-Tonsillectomy Pain and Vomiting: role of Per-Operative Steroids.
J Saidu Med Col Jan ;8(2):54-8.

Background: Vomiting and severity of throat pain in adults undergoing tonsillectomy by dissection method under standard general anesthesia. Objectives: To evaluate the effects of single pre-operative dose of dexamethasone with the frequency of post-operative tonsilectomy pain and vomiting. Material & Methods: This was a randomized control trial conducted in ENT Department, Saidu Teaching Hospital Swat, from January 2017 to October 2017. Adults of either gender aged between 14-24 years, undergoing tonsillectomy were divided into two groups of 45 each. One group was selected to receive dexamethasone 0.1mg/kg (maximum of 8 mg); the second group was given equivalent volume of saline, per-operatively. The frequency of vomiting was assessed 6 hours post-operatively. Mean score of postoperative throat pain were compared in both groups. Severity of throat pain was monitored by Visual Analogue Scale (VAS) score 0-10 after 3,6,10 and 24 hours of extubation. Results: Dexamethasone group showed significantly less postoperative vomiting (17.8%, n = 8) as compared to placebo (73.3%, n = 33) group (p < 0.05). Pain score was also significantly lower and swallowing was less painful in patients after 3,6,10 and 24 hours in dexamethasone group. Pain score on the average was 0.8, 1.2 factors less in dexamethasone group than in saline group in first 24 hours on a VAS score of 1 -10. Conclusion: Pre-operative intravenous dexamethasone reduced postoperative vomiting and pain significantly in adults undergoing tonsillectomy by dissection method.

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