The Effect of a Postoperative Course of Oral Prednisone on Postoperative Morbidity following Childhood Tonsillectomy

Objective. Tonsillectomy is a common procedure with a wide range of described operative techniques and usage of perioperative medications. Single-dose intraoperative dexamethasone has been shown to decrease postoperative nausea and pain and improve return to normal diet. The aim was to determine if a course of oral postoperative steroids would further decrease postoperative morbidity following tonsillectomy in children. Study Design. Randomized, placebo-controlled, double-blinded trial. Power analysis recommended 198 participants. Setting. A university hospital and private hospital. Subjects and Methods. The authors compared a 5-day course of oral prednisolone with placebo in a pediatric population (3-16 years) undergoing tonsillectomy to assess effects on postoperative pain, nausea, and vomiting and return to normal function. They also assessed the effect of corticosteroids on sleep duration and aspects of sleep quality. Results. The results showed no significant difference between the 2 groups when analyzed for differences in the above variables both overall and at each of the postoperative 10 time points (pain, P=.478; nausea and vomiting, P=.556; return to normal diet well, P=.234; return to normal activity, P=.668; bedtime, P=.056; number of times awake during the night, P=.593). Conclusion. There is no evidence of benefit from postoperative administration of corticosteroids in pediatric patients recovering from tonsillectomy.