Children undergoing tonsillectomy who receive perioperative corticosteroid therapy — as recommended by current guidelines to reduce postoperative nausea and vomiting — do not face increased risk for postoperative bleeding, according to a JAMA study.

In response to a study suggesting such steroid use increases hemorrhage after tonsillectomy, researchers randomized some 300 children to perioperative intravenous dexamethasone or placebo. During the 14 days after tonsillectomy, rates of bleeding that required hospitalization or surgical repair (so-called level II or III bleeds) did not differ between the groups.

Level I bleeds — defined as any reported bleeding event, regardless of clinical evidence — were more common with dexamethasone than with placebo (11 vs. 7 events). However, the authors point out that such events tended to be “nondescript and self-limited.” Level II and III bleeds, they say, “are a more reliable indicator for complications.”

Source: JAMA