The efficacy of Perioperative steroid therapy in pediatric primary palatoplasty

• Published in: The Cleft palate-craniofacial journal Vol. 36; no. 4; pp. 340 - 344
• Main Authors: SENDERS, C. W, DI MAURO, S. M, BRODIE, H. A, EMERY, B. E, SYKES, J. M
• Format: Journal Article
• Language: English
• Published: Chapel, Hill, NC American Cleft Palate-Craniofacial Association 01-07-1999; SAGE PUBLICATIONS, INC
• Subjects: Biological and medical sciences; Cleft Palate - drug therapy; Cleft Palate - surgery; Dentistry; Dexamethasone - administration & dosage; Dexamethasone - analogs & derivatives; Double-Blind Method; Ent. Stomatology; Female; Glucocorticoids - administration & dosage; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Infant; Injections, Intravenous; Male; Medical sciences; Palate - surgery; Pharmacology. Drug treatments; Postoperative Care; Postoperative Complications - prevention & control; Preoperative Care; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Time Factors; Human; Plasty; Prospective; Corticosteroid; Chemotherapy; Surgery; Treatment efficiency; Primary; Clinical trial; Palate; Combined treatment; Child
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1597/1545-1569(1999)036<0340:TEOPST>2.3.CO;2

To determine if perioperative steroid therapy benefits pediatric primary palatoplasty patients.
A prospective, double-blind, randomized trial with a placebo control.
An academic medical center.
Forty-five children undergoing primary repair of their cleft palate between 1989 and 1996 who were under the age of 48 months and without developmental delay or any associated syndrome.
Intravenous dexamethasone sodium phosphate (0.25 mg/kg) or a placebo (5% dextrose in water) immediately preoperatively and once every 8 hours for two doses postoperatively.
Postoperative airway distress, fever, oral fluid intake, discharge eligibility, and palatal fistula formation.
Perioperative steroid therapy significantly reduced the incidence of postoperative airway distress (p = .05) and postoperative fever (p = .02); postoperative oral fluid intake, discharge eligibility, and palatal fistula formation were not significantly affected.
Perioperative steroids effectively lower the risk of postoperative airway distress and postoperative fever in children undergoing the primary repair of their cleft palate. This finding favors a customary role for perioperative steroid therapy in pediatric primary palatoplasty.