A Comparison of Oral and Intravenous Steroid on Postoperative Pain in Adult Tonsillectomy: A Double - blind Randomized Controlled Trial
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Abstract
BACKGROUND: Tonsillectomy is one of the most common procedures performed by otolaryngologists; even though it is not a complicated procedure, patients suffer from post - operative pain, nausea, and vomiting leading to dehydration, malnutrition, and prolong hospital stay.
OBJECTIVES: To evaluate the effect of oral prednisolone, intravenous dexamethasone for post - tonsillectomy pain and morbidities.
METHODS: All 90 adult patients scheduled for elective tonsillectomy were included. The participants were then randomly assigned into three groups, Group 1. to receive a seven - day post - operative course of oral prednisolone (0.1 mg/kg/day, maximum 30 mg/day), Group 2. To receive a single dose of intravenous dexamethasone perioperative (0.1 mg/kg, maximum 10 mg), then placebo, and Group 3. To receive a placebo over seven days. Post - operative pain was noted using a Visual Analogue Scale; the presence of nausea and vomiting, pain affecting work, sleep, and swallowing, the amount of paracetamol consumption, and weight loss was assessed conducted using questionnaires. All patients were followed up on days seven and fourteen.
RESULTS: Statistically significant differences in pain reduction were observed in the prednisolone group on days 5, 6, and 7 post - operative (p = 0.01, 0.016, 0.007 respectively), but no statistically significant differences in pain for the dexamethasone and prednisolone group for the other days post - operation. No statistically significant differences in the presence of nausea and vomiting, pain affected to work, sleep and swallowing, amount of paracetamol consumption, and weight loss.
CONCLUSIONS: A seven - day course of oral prednisolone may benefit recovery from a tonsillectomy without any serious complications.
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References
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