Aim: Since tonsillectomy surgeries performed in the pediatric age group have a high rate of postoperative nausea and vomiting (PONV), the prophylactic antiemetic application is common. This study aimed to evaluate the benefits of systemic administration of a low dose of methylprednisolone (1mg.kg-1) for the prevention of PONV in children after adenotonsillectomy.
Materials and methods: In this study, the files of children undergoing adenotonsillectomy between 1.08.2015/31.01.2018 in our hospital were analyzed retrospectively. Patients who were given 1mg.kg-1 methylprednisolone as IV in premedication Group P; Patients who received 0.15mg.kg-1 metoclopramide HCl was grouped as Group M. Effects on PONV, vomiting attacks, oral intake time and quality, postoperative analgesic requirement, postoperative respiratory complications, and drug side effects were listed.
Results: 408 children aged 4-12 years were included in the study. Vomiting rates between 1-4 hours (late period) are 11.0% in Group M (n=22); It was 3.8% (n=8) in Group P. In the late period, a significant difference was found between the two groups in terms of nausea and vomiting (p=0.02, p=0.07, respectively). In Group M, the incidence of respiratory complications was also higher in the postoperative period compared to Group P. Acetaminophen requirement increased significantly in group M compared to Group P (p=0.006).
Conclusion: Prophylactic use of a single dose of 1 mg-kg-1 IV methylprednisolone during the preoperative period reduced the incidence of late postoperative vomiting compared to the use of metoclopramide HCl and led to earlier initiation of oral nutrient intake. In addition to its anti-inflammatory properties and antiemetic effects, low-dose methylprednisolone is also particularly useful for possible respiratory complications.
Key words: Methylprednisolone, Metoclopramide Hydrochloride, PONV, Respiratory complications, Tonsillectomy
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