Background: Adenoidectomies and tonsillectomies are common paediatric procedures, however, may be accompanied by severe postoperative complications. We evaluated the effects of preoperative dexamethasone and relaxant-free anaesthesia on adenotonsillectomy outcome in a low-resource setting (LRS).
Methods: This retrospective study was conducted at UNIOSUN Teaching Hospital (UTH), Osogbo, Nigeria. Records of 112 patients, aged 2 – 10 years, with American Society of Anesthesiologists (ASA) status I and II, were retrieved and separated. Group A had relaxant-free anaesthesia and IV dexamethasone 4mg both overnight and at induction, while group B had conventional anaesthesia, without the above modalities., Postoperative numerical rating scale (NRS) pain scores, nausea and vomiting (PONV), bleeding, respiratory problems, and home readiness were compared.
Results: Demographics i.e., mean age (3.8 ± 1.6 vs 5.2 ± 2.2 years), male 28 (43.8%) vs 22 (45.8%), female 36 (56.2%) vs 26 (54.2%) and, body mass index (BMI) 22.18 vs 24.22 kg/m,2 were comparable, between group A and B, respectively. The mean postoperative NRS pain score was 2.2 ± 0.4 in group A, which is statistically lower than 3.6 ± 0.8 in group B, with p-value 0.011. PONV was 12 (18.6%) in group A, which was lower than 14 (29.2%) in group B, p-value 0.001. Bleeding was similar in both groups, p-value 0.332. Incidence of respiratory problems was 6 (9.4%) in group A, which is lower than 7 (14.6%) in group B, p-value 0.012. Time to home readiness was 24.2 ± 4.6 hours in group A, which is lower than 36.4 ± 6.2 hours in group B, p-
value < 0.001 (Table 2).
Conclusion: Preoperative dexamethasone and relaxant-free anaesthesia reduces postoperative NRS pain scores, PONV, and respiratory problems, and promotes home readiness in paediatric adenotonsillectomies. This technique is beneficial and improves surgical outcome in LRS.
