Efficacy of single dose preoperative intravenous dexamethasone for postoperative pain relief in tonsillectomy patients


  • Lakhan M. S. Department of ENT, Yenpoya Medical College, Mangalore, Karnataka, India
  • Sharwak Ramlan Department of ENT, Yenpoya Medical College, Mangalore, Karnataka, India
  • Gangadhara Somayaji Department of ENT, Yenpoya Medical College, Mangalore, Karnataka, India




Tonsillitis, Tonsillectomy, Pain relief, Dexamethasone


Background: Tonsillectomy is one of the most commonly performed surgical procedures in otolaryngology. For managing post tonsillectomy pain, different modalities like use of intravenous opioids, NSAIDS, local anaesthetics, nerve blocks and steroids are available. The aim of this study is to determine the efficacy of single dose preoperative intravenous dexamethasone for postoperative pain relief in patients undergoing tonsillectomy.

Methods: This study was conducted with 120 patients who underwent tonsillectomy. Patients were divided into two groups of 60, where one group received preoperative dexamethasone. Postoperative pains of both groups were assessed.  

Results: There is significant difference in pain in both the groups in 6th and 12th postoperative hours, but in 2nd hour there is no significant difference.

Conclusions: A single dose of preoperative intravenous dexamethasone significantly decreased the postoperative pain in tonsillectomy patients.


Author Biography

Lakhan M. S., Department of ENT, Yenpoya Medical College, Mangalore, Karnataka, India





Buland K, Zahoor MU, Asghar A, Khan S, Zaid AY. Efficacy of single dose perioperative intravenous steroid (dexamethasone) for post-operative pain relief in tonsillectomy patients. J Coll Physicians Surg Pak. 2012;22(6):349-52.

Gupta AK, Gupta S, Meena DS, Sharma U. Post-tonsillectomy pain: different modes of pain relief. Indian J Otolaryngol Head Neck Surg. 2002;54(2):136-9.

Hashmi MA, Ahmed A, Aslam S, Mubeen M. Post-tonsillectomy pain and vomiting: role of pre-operative steroids. J Coll Physicians Surg Pak. 2012;22(8):505-9.

Lalwani AK. Current diagnosis and treatment in otolaryngology-head and neck surgery. McGraw-Hills Int Ed. 2004;19:361.

Muhammad R, Hussain A, Ullah A, Anwar K, Iqbal J, Khan M. Effects of perioperative steroids in tonsillectomy using sharp dissection technique in adults on first postoperative day: Ann Pak Inst Med Sci. 2012;8(3):165-7.

Afman CE, Welge JA, Steward DL. Steroids for post-tonsillectomy pain reduction: meta-analysis of randomized controlled trials. Otolaryngol Head Neck Surg. 2006;134(2):181-6.

Hanasono MM, Lalakea ML, Mikulec AA, Shepard KG, Wellis V, Messner AH. Perioperative steroids in tonsillectomy using electrocautery and sharp dissection techniques. Arch Otolaryngol Head Neck Surg. 2004;130(8):917-21.

Anderson HA, Rice BJ, Cantrell RW. Effects of injected deposteroid on posttonsillectomy morbidity: a double-blind study. Arch Otolaryngol. 1975;101(2):86-8.

Papangelou L. Steroid therapy in tonsillectomy. The Laryngoscope. 1972;82(2):297-302.

Ohlms LA, Wilder RT. Use of intraoperative corticosteroids in pediatric tonsillectomy. Arch Otolaryngol Head Neck Surg. 1995;121(7):737-42.

April MM, Callan ND, Nowak DM, Hausdorff MA. The effect of intravenous dexamethasone in pediatric adenotonsillectomy. Arch Otolaryngol Head Neck Surg. 1996;122(2):117-20.

Splinter WM, Roberts DJ. Dexamethasone decreases vomiting by children after tonsillectomy. Anesth Analg. 1996;83(5):913-6.

Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, et al. Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2007;105(6):1615-28.

Henzi I, Walder B, Tramer MR. Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review. Anesth Analg. 2000;90(1):186-94.

Mann DG, St George C, Scheiner E, Granoff D, Imber P, Mlynarczyk FA. Tonsillectomy—some like it hot. Laryngoscope. 1984;94(5):677-9.

Nunez DA, Provan J, Crawford M. Postoperative tonsillectomy pain in pediatric patients: electrocautery (hot) vs. cold dissection and snare tonsillectomy—a randomized trial. Arch Otolaryngol Head Neck Surg. 2000;126(7):837-41.

Hargreaves KM, Costello A. Glucocorticoids suppress levels of immunoreactive bradykinin in inflamed tissue as evaluated by microdialysis probes. Clin Pharmacol Ther. 1990;48(2):168-78.

Li H, Xie W, Strong JA, Zhang JM. Systemic antiinflammatory corticosteroid reduces mechanical pain behavior, sympathetic sprouting, and elevation of proinflammatory cytokines in a rat model of neuropathic pain. Anesthesiology. 2007;107(3):469-77.

Vosdoganis F, Baines D. The effect of single dose intravenous dexamethasone in tonsillectomy in children. Anaesth Intensive Care. 1999;27(5):489-92.

Hermans V, De Pooter F, De Groote F, De Hert S, Van der Linden P. Effect of dexamethasone on nausea, vomiting, and pain in paediatric tonsillectomy. Br J Anaesth. 2012;109(3):427-31.

Giannoni C, White S, Enneking FK. Does dexamethasone with preemptive analgesia improve pediatric tonsillectomy pain? Otolaryngol Head Neck Surg. 2002;126(3):307-15.

Lachance M, Lacroix Y, Audet N, Savard P, Thuot F. The Use of Dexamethasone to Reduce Pain After Tonsillectomy in Adults: A Double‐Blind Prospective Randomized Trial. Laryngoscope. 2008;118(2):232-6.






Original Research Articles