Abstract
Objective
To determine if perioperative steroid therapy benefits pediatric primary palatoplasty patients.
Design
A prospective, double-blind, randomized trial with a placebo control.
Setting
An academic medical center.
Patients
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.
Interventions
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.
Main outcome measures
Postoperative airway distress, fever, oral fluid intake, discharge eligibility, and palatal fistula formation.
Results
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.
Conclusions
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.
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