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The Effect of Perioperative Betamethasone on Post-operative Nausea, Vomiting and Pain in Children Undergoing Tonsillar Surgery

Published online by Cambridge University Press:  01 May 2010

Ulrica Johansson ,
Carola Sundgren ,
Krister Tano  and
Johannes van den Berg
Ulrica Johansson
Affiliation:
Department of Pediatric, Sunderby Hospital, Luleå, Sweden
Carola Sundgren
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden
Krister Tano
Affiliation:
ENT Department, Sunderby Hospital, Luleå and Department of Clinical Science, Otorhinolaryngology, University of Umeå, Umeå, Sweden
Johannes van den Berg*
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden
*
Correspondence to: Johannes van den Berg, RN, PhD, Senior lecturer, Division of Pediatrics/Barnavdelning 4, University Hospital Umeå, 901 85 Umeå, Sweden. E-mail: johannes.berg@pediatri.umu.se
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Abstract

Objectives

:To investigate if a single dose of betamethasone given perioperatively could reduce common post-operative problems such as vomiting, nausea and pain in children undergoing tonsillar surgery.

Background

:Post-operative nausea and vomiting (PONV) are common problems after surgery caused by several perioperative factors, such as post-operative pain. Prophylactic treatment of PONV can be effective in improving recovery after surgery. Studies have shown that the use of a single dose of dexamethasone during tonsillectomies in children was efficient against PONV. Dexamethasone is not available in Sweden for intravenous administration; betamethasone was thought to be an alternative.

Method

:The study was a retrospective cohort study including 69 children who underwent tonsillar surgery. A single dose of betamethasone perioperatively was introduced to a group of 32 children, to reduce PONV while 37 children did not receive betamethasone. Data were received from the medical records and from a post-operative questionnaire.

Results

:No significant differences for children undergoing tonsillar surgery regarding the prevalence of PONV between the betamethasone group and the non-betamethasone group were found. This was maybe due to a comparatively low dose of betamethasone. However, the given dose was sufficient to significantly reduce post-operative pain.

Keywords

BetamethasoneChildrenPONVTonsillectomyPain
Type
Original Articles
Information
British Journal of Anaesthetic & Recovery Nursing , Volume 11 , Issue 2 , May 2010 , pp. 24 - 29
Copyright
Copyright © British Association of Anaesthetic and Recovery Nursing 2010

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References

Aasboe, V, Raeder, JC, Groegaard, B. Betamethasone reduces postoperative pain and nausea after ambulatory surgery. Anesthesia & Analgesia 1998; 87 (2): 319–323.CrossRefGoogle ScholarPubMed
Aouad, MT, Siddik, SS, Rizk, LB, Zaytoun, GM, Baraka, AS. The effect of dexamethasone on postoperative vomiting after tonsillectomy. Anesthesia & Analgesia 2001; 92 (3): 636–640.CrossRefGoogle ScholarPubMed
Belloso, A, Chidambaram, A, Morar, P, Timms, MS. Coblation tonsillectomy versus dissection tonsillectomy: postoperative hemorrhage. Laryngoscope 2003; 113 (11): 2010–2013.CrossRefGoogle ScholarPubMed
Burton, MJ, Doree, C. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database of Systematic Reviews 2007, Issue 3. Art No.: CD004619. DOI: 10.1002/14651858.CD004619.pub2CrossRefGoogle ScholarPubMed
Carney, AS, Harris, PK, MacFarlane, PL, Nasser, S, Esterman, A. The coblation tonsillectomy learning curve. Otolaryngology – Head and Neck Surgery 2008; 138 (2): 149–152.CrossRefGoogle ScholarPubMed
Chang, KW. Randomized controlled trial of Coblation versus electrocautery tonsillectomy. Otolaryngology – Head and Neck Surgery 2005; 132 (2): 273–280.CrossRefGoogle ScholarPubMed
Czarnetzki, C, Elia, N, Lysakowski, C, Dumont, L, Landis, BN, Giger, R, Dulguerov, P, Desmeules, J, Tramer, MR. Dexamethasone and risk of nausea and vomiting and postoperative bleeding after tonsillectomy in children: a randomized trial. The Journal of the American Medical Association 2008; 300 (22): 2621–2630.CrossRefGoogle ScholarPubMed
De Negri, P, Ivani, G. Management of postoperative nausea and vomiting in children. Paediatric Drugs 2002; 4 (11): 717–728.CrossRefGoogle ScholarPubMed
Elhakim, M, Ali, NM, Rashed, I, Riad, MK, Refat, M. Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy. Canadian Journal of Anesthesia 2003; 50 (4): 392–397.CrossRefGoogle ScholarPubMed
Fazel, MR, Yegane-Moghaddam, A, Forghani, Z, Aghadoost, D, Mahdian, M, Fakharian, E. The effect of dexamethasone on postoperative vomiting and oral intake after adenotonsillectomy. International Journal of Pediatric Otorhinolaryngology 2007; 71 (8): 1235–1238.CrossRefGoogle ScholarPubMed
Kaan, MN, Odabasi, O, Gezer, E, Daldal, A. The effect of preoperative dexamethasone on early oral intake, vomiting and pain after tonsillectomy. International Journal of Pediatric Otorhinolaryngology 2006; 70 (1): 73–79.CrossRefGoogle ScholarPubMed
Karlsson, E, Larsson, LE, Nilsson, K. Postanaesthetic nausea in children. Acta Anaesthesiologica Scandinavica 1990; 34 (7): 515–518.CrossRefGoogle ScholarPubMed
Kim, MS, Cote, CJ, Cristoloveanu, C, Roth, AG, Vornov, P, Jennings, MA, Maddalozzo, JP, Sullivan, C. There is no dose-escalation response to dexamethasone (0.0625–1.0 mg/kg) in pediatric tonsillectomy or adenotonsillectomy patients for preventing vomiting, reducing pain, shortening time to first liquid intake, or the incidence of voice change. Anesthesia & Analgesia 2007; 104 (5): 1052–1058.CrossRefGoogle ScholarPubMed
Liechti, M, Feurer, R, Gross, D, Schmitz, A, Stutz, K, Gerber, A, Weiss, M. Prevention of postoperative nausea and vomiting in children following adenotonsillectomy, using tropisetron with or without low-dose dexamethasone. Journal of Anesthesia 2007; 21 (3): 311–316.CrossRefGoogle ScholarPubMed
McKeage, K, Simpson, D, Wagstaff, AJ. Intravenous droperidol: a review of its use in the management of postoperative nausea and vomiting. Drugs 2006; 66 (16): 2123–2147.CrossRefGoogle ScholarPubMed
Olutoye, O, Watcha, MF. Management of postoperative vomiting in pediatric patients. International Anesthesiology Clinics 2003; 41 (4): 99–117.CrossRefGoogle ScholarPubMed
Steward, DL, Welge, J, Myer, C. Steroids for improving recovery following tonsillectomy in children. Cochrane Database of Systematic Reviews 2003, Issue 1. Art No.: CD003997. DOI: 10.1002/14651858.CD003997CrossRefGoogle ScholarPubMed
Temple, RH, Timms, MS. Paediatric coblation tonsillectomy. International Journal of Pediatric Otorhinolaryngology 2001; 61 (3): 195–198.CrossRefGoogle ScholarPubMed
Watcha, MF, White, PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 1992; 77 (1): 162–184.CrossRefGoogle ScholarPubMed
Windfuhr, JP, Schloendorff, G, Baburi, D, Kremer, B. Lethal outcome of post-tonsillectomy hemorrhage. European Archives of Oto-Rhino-Laryngology 2008; 265 (12): 1527–1534.CrossRefGoogle ScholarPubMed