BACKGROUND The efficacy of dexamethasone (DEX) to reduce morbidity after paediatric tonsillectomy remains controversial. We evaluated the effect of 0.15 and 0.5 mg kg(-1) DEX on the incidence of postoperative nausea and vomiting (PONV) and on pain intensity after paediatric tonsillectomy. METHODS A total of 147 children aged 2-8 yr undergoing elective tonsillectomy were included in this prosp...

OBJECTIVE To examine whether microdebrider intracapsular tonsillotomy (MT) results in less postoperative pain compared with electrosurgical extracapsular tonsillectomy (ET). DESIGN Prospective, randomized, double-blind, matched pair, clinical trial. SETTING Specialty care hospital. Patients Twelve male (48%) and 13 female (52%) children aged 5 to 15 years, with obstructive tonsillar hyperpl...

OBJECTIVE This trial aimed to compare the guillotine technique of tonsillectomy with 'cold steel' dissection, the current 'gold standard'. DESIGN A single centre, randomised, controlled trial. METHODS One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operati...

OBJECTIVES/HYPOTHESIS The aim of this study was to compare use of hemostatic glues to conventional techniques of intraoperative hemostasis for tonsillectomy. STUDY DESIGN A systematic review of the literature and meta-analysis. METHODS All published prospective controlled trials that compared hemostatic glues to conventional techniques of hemostasis were identified. We performed a meta-anal...

OBJECTIVE To evaluate the effects of a single pre-operative dose of dexamethasone with the frequency of postoperative vomiting and severity of throat pain in children undergoing electrocautery tonsillectomy under standard general anaesthesia. STUDY DESIGN Randomised controlled trial. PLACE AND DURATION OF STUDY ENT Department, Combined Military Hospital, Kharian, from January to December 20...

OBJECTIVE To evaluate efficiency and postoperative morbidity in tonsillectomy using the harmonic scalpel (HS) vs conventional electrocautery (EC). DESIGN A retrospective medical chart review of all patients who underwent tonsillectomy at a single children's hospital during a 32-month period from January 2001 to August 2003. PATIENTS The charts of 605 patients who underwent tonsillectomy or ...

We discuss a case of severe respiratory depression in a child, with ultrarapid CYP2D6 genotype and obstructive sleep apnea syndrome, after taking tramadol for pain relief related to a day-case tonsillectomy.