The effect of perioperative dexamethasone dosing on post-tonsillectomy hemorrhage risk

Abstract Objectives Dexamethasone is currently recommended for routine prophylaxis against postoperative nausea and vomiting after tonsillectomy procedures. However, some studies have raised concern that dexamethasone use may lead to higher rates of post-tonsillectomy hemorrhage. Our objective was t...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2017-07, Vol.98, p.19-24
Main Authors: Yiu, Yin, MD, Mahida, Justin B., MD, Cooper, Jennifer N., PhD, Elsey, Nicole M., MD, Deans, Katherine J., MD MHSc, Minneci, Peter C., MD MHSc, Merrill, Tyler B., BA, Tobias, Joseph D., MD, Elmaraghy, Charles A., MD
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Cohort Studies
Dexamethasone - administration & dosage
Dexamethasone - adverse effects
Female
Glucocorticoids - administration & dosage
Glucocorticoids - adverse effects
Humans
Logistic Models
Male
Otolaryngology
Pediatrics
Perioperative steroids
Post-tonsillectomy hemorrhage
Postoperative Hemorrhage - epidemiology
Postoperative Hemorrhage - etiology
Postoperative Nausea and Vomiting - drug therapy
Retrospective Studies
Risk
Tonsillectomy
Tonsillectomy - adverse effects
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Summary:Abstract Objectives Dexamethasone is currently recommended for routine prophylaxis against postoperative nausea and vomiting after tonsillectomy procedures. However, some studies have raised concern that dexamethasone use may lead to higher rates of post-tonsillectomy hemorrhage. Our objective was to determine whether higher doses of dexamethasone administered perioperatively during tonsillectomy procedures are associated with an increased risk of secondary post-tonsillectomy hemorrhage. Methods We conducted a retrospective review of 9843 patients who underwent tonsillectomy and received dexamethasone at our institution from January 2010 to October 2014. We compared the dose of dexamethasone administered to patients who did and did not develop secondary post-tonsillectomy hemorrhage using Mann Whitney U tests. Multivariable logistic regression models were used to evaluate the association between dexamethasone dose and post-tonsillectomy hemorrhage after adjustment for demographic and clinical characteristics. Results A total of 280 (2.8%) patients developed secondary post-tonsillectomy hemorrhage. Patients who developed hemorrhage tended to be older (median (interquartile range) 7 (4-11) vs. 5 (3-8) years), p
ISSN:0165-5876
1872-8464
DOI:10.1016/j.ijporl.2017.04.033