Does dexamethasone with preemptive analgesia improve pediatric tonsillectomy pain?

Otolaryngol Head Neck Surg. 2002 Mar;126(3):307-15. doi: 10.1067/mhn.2002.122700.


Objective: The study goal was to determine whether the combination of dexamethasone with preemptive analgesia has an additive effect in further improving recovery.

Study design: We conducted a prospective, randomized, double-blinded trial of 50 children undergoing tonsillectomy at a university ambulatory surgery center. One study group received 1 intravenous dose of dexamethasone, and another group received 1 dose of saline solution. All patients received tonsillar fossa injections of ropivacaine plus clonidine before tonsil excision.

Results: The 2 study groups were similar in main outcome measurements. Pain intensity and quality of life were not statistically different between the groups. There was a small trend to less trismus and less cumulative codeine use in the steroid group. Overall, there was a very low incidence of nausea and vomiting in both groups, which may have been due to the preemptive analgesia.

Conclusion: Dexamethasone does not significantly improve the morbidity of pediatric tonsillectomy when preemptive analgesia with ropivacaine and clonidine is used concurrently.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Amides
  • Analysis of Variance
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Child
  • Child, Preschool
  • Clonidine
  • Dexamethasone / therapeutic use*
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Preanesthetic Medication*
  • Quality of Life
  • Ropivacaine
  • Tonsillectomy / adverse effects*


  • Amides
  • Anti-Inflammatory Agents, Non-Steroidal
  • Ropivacaine
  • Dexamethasone
  • Clonidine