Steroids for Post-Tonsillectomy Pain Reduction: Meta-Analysis of Randomized Controlled Trials

Abstract

OBJECTIVES: To determine whether meta-analysis supports the use of corticosteroids to reduce post-tonsillectomy pain for pediatric patients. METHODS: A systematic review of currently available randomized controlled trials using a single-dose, intravenous corticosteroid during pediatric tonsillectomy was performed. Visual analog pain scale (VAS) data was extracted with reviewers blinded to results. Meta-analysis was performed with weighted mean difference and random-effects model using Revman 4.2 software. RESULTS: Eight randomized trials were included in analysis of post-tonsillectomy pain. A statistically significant reduction in pain as measured by VAS on postoperative day 1 was noted (mean VAS difference = −0.97; CI 95 % = −1.74,−0.19; P = 0.01). CONCLUSIONS: A single, intraoperative dose of dexamethasone may reduce post-tonsillectomy pain on postoperative day 1, by a factor of 1 on a 10-point pain scale. As the side effects and cost of dexamethasone dose appear negligible, consideration of routine use seems reasonable.