The Effect of Single Dose Dexamethasone on Postoperative Pain after Tonsillectomy

Open Access

Abstract

Introduction: Tonsillectomy is a frequently performed ENT surgery, which is mostly done for recurrent tonsillitis or obstructive tonsillar hypertrophy. This study aimed to investigate the influence of a single dose of dexamethasone on postoperative pain intensity. Methods & Materials: This was a prospective randomised controlled study conducted in the Department of Anaesthesiology at Faridpur General Hospital, during the period from January 2025 to December 2025. A total of 100 patients scheduled for tonsillectomy surgery due to recurrent tonsillitis or tonsillar hypertrophy were included in the study. Data were analysed using the computer software SPSS version 26.0. Result: Dexamethasone brought down third, day post, surgery pain by nearly a half scale on the VAS scale (4.8 vs 6.2 at 6 h; 2.0 vs 3.1 on day 5, p < 0.001), and helped reduce the need for rescue analgesia by more than half (36% vs 68%, p = 0.002). Dexamethasone also helped patients return to normal oral intake sooner (60% vs 32% within 6 h, p = 0.01). There were fewer cases of postoperative nausea and vomiting (12% vs 36%), and the overall rate of complications was lower (14% vs 40%, p = 0.01) despite the groups being matched for age, gender, and haemorrhage rates. Conclusion: The trial revealed that a single dose of dexamethasone during surgery greatly improved post-tonsillectomy recovery. Patients who received dexamethasone had less pain at all times, used fewer pain medications (36% vs 68%), started oral intake earlier (60% vs 32% in 6 hours), had less nausea and vomiting (12% vs 36%), and had no significant difference in postoperative bleeding (2% vs 4%).