Impact of Dexamethasone on Cytokine-Mediated Inflammation and Pain Relief in Pediatric Tonsillectomy: A Randomized Controlled Trial
نویسندگان
1 Otorhinolaryngology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
2 Otorhinolaryngology Department, Armed Forces College of Medicine, Cairo, Egypt
3 Microbiology and Immunology Department, Faculty of Medicine Al-Azhar University, Damietta, Egypt
4 Otorhinolaryngology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
5 Department of ENT, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
6 Otorhinolaryngology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
7 Otorhinolaryngology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
8 Otorhinolaryngology Department, Armed Forces College of Medicine, Cairo, Egypt
9 Community and Occupational Medicine Department, Faculty of Medicine for Girls Al-Azhar University, Cairo, Egypt
10 Otorhinolaryngology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
11 Otorhinolaryngology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
doi
10.48309/jmcs.2026.548326.2876چکیده
Tonsillectomy is a common surgical procedure performed in pediatric patients, often resulting in postoperative pain. This study was conducted to assess the role of intraoperative dexamethasone in relieving pain after adenotonsillectomy, potentially through modulation of proinflammatory cytokine levels, particularly TNF-α and IL-6. A prospective randomized controlled trial was conducted at El-Zahraa Hospital, Al-Azhar University Faculty of Medicine for girls, from January 2023 to October 2023. The total sample size of the children in this study was 120, with ages ranging from 3 to 7 years. Sixty children were enrolled and randomly allocated into two groups: a dexamethasone group and a placebo group. The dexamethasone group received a single dose of intravenous dexamethasone during anesthesia induction. Serum inflammatory biomarkers interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured in blood samples in both groups, taken at preoperative day 0 and 7 days postoperatively, and analyzed by using Enzyme-linked immunosorbent assay (ELISA). Patients were instructed to complete the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) questionnaire from the day of surgery until the seventh postoperative day. Data were analyzed statistically using SPSS version 20. Intravenous dexamethasone significantly decreased serum levels of both IL-6 and TNF-α and also significantly decreased postoperative pain scores after adenotonsillectomy (p ˂ 0.05). On the third and seventh days after surgery, 76.7% of dexamethasone group participants had pain scores of 6 or higher on the CHEOPS scale compared to 100% of placebo group participants (p ˂ 0.05). Intravenous dexamethasone is beneficial in reducing post-adenotonsillectomy discomfort. Dexamethasone's pain-relieving benefits may be due to its ability to modulate cytokine production and reduce inflammation. This research emphasizes the efficacy of dexamethasone as an additional treatment during tonsillectomy operations, providing better pain control and patient comfort.
