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Intravenous Dexamethasone decreases opioid use during pediatric tonsillectomies without raising the risk of bleeding.
In a systematic review and meta-analysis published in the “Canadian Journal of Anesthesia”, intravenous administration of Dexamethasone effectively reduced opioid use during pediatric tonsillectomies without escalating the risk of postoperative hemorrhage. Investigators sought to explore the effects of Dexamethasone on opioid consumption for tonsil removal procedures in children.
Databases like Web of Science, Cochrane Database, Embase, and MEDLINE were searched for trials comparing intravenous Dexamethasone versus placebo for pediatric tonsil excision. Researchers analyzed perioperative opioid consumption as the primary outcome and postoperative hemorrhage as the secondary outcome, using a random effects model. Out of 1,329 studies reviewed, 16 were included in the analysis.
As found, intravenous use of Dexamethasone markedly diminished opioid consumption by 0.11 mg·kg⁻¹. Importantly, it did not increase the rates of readmission (risk ratio [RR]: 0.69) or reoperation due to hemorrhage (RR: 3.67). To sum up, Dexamethasone was effective in curtailing opioid needs during pediatric tonsil surgery without heightening the risk of postoperative bleeding, thus offering a safe pain management option.
Canadian Journal of Anaesthesia
Effects of dexamethasone on opioid consumption in pediatric tonsillectomy: a systematic review with meta-analysis
Naoko Niimi et. al.
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