Steroids for post-tonsillectomy pain reduction: Meta-analysis of randomized controlled trials

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 oil postoperative day I was noted (mean VAS difference = -0.97 Cl 95 % = -1.74,-0.19 P = 0.01). CONCLUSIONS: A single, intraoperative close of dexamethasone may reduce post-tonsillectomy pain oil postoperative day 1, by a factor of 1 on a 10-point pain scale. As the side effects and cost of dexamethasone close appear negligible, consideration of routine use seems reasonable.