***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Summary A main reason for investigating the clinical effects and possible merits of post-operative corticosteroid administration was its practical implication s in traumatology . It was also hoped to obtain information relevant to the analgesic activity of steroid . A crossover study has been done in 12 healthy subjects , each of whom had two separate , but identical operations for removal of non-erupted 3rd molar teeth on each side of the jaw . 3 h after surgery , either betamethasone 9 mg ( Celeston Chronodose ® ) or placebo was injected intramuscularly in a r and omized fashion . A paired comparison was made of the post-operative courses . All but 1 patient experienced less pain after the steroid injection . Surprisingly , some patients reported pronounced relief within min after the injection , whereas in others there was a time-lag . Swelling , measured on the 3rd day , was reduced by 47 % after the steroid as compared to placebo . There was poor agreement between the steroid-induced reductions in pain and swelling . This exemplifies the dissociation between pain and other inflammatory events , and indicates that the analgesic and anti-inflammatory properties of a steroid may depend on discrete mechanisms , which may show considerable individual variation . From overall assessment , all 12 patients favoured the post-operative course when the steroid was administered . Almost the same levels of pain relief , reduction in swelling , and preference were reached in the present patients , who received the steroid 3 h post-operatively , as had previously been found in a similar trial in which the drug was injected prior to surgery . The results suggest that short term corticosteroid administration may be a valuable means of reducing pain and excessive inflammatory response after surgical or accidental soft tissue/bone injury OBJECTIVE To determine the effect of preoperative dexamethasone sodium phosphate administration on posttonsillectomy morbidity for electrocautery ( " hot " ) and sharp ( " cold " ) dissection techniques . DESIGN Prospect i ve , r and omized , double-blind study . SETTING University pediatric hospital and county teaching hospital . Subjects A total of 219 children , aged 9 months to 12 years , undergoing tonsillectomy .  Intervention Participants who underwent tonsillectomy  were r and omly assigned to receive either intravenous dexamethasone sodium phosphate ( 1 mg/kg ) or placebo . OUTCOME MEASURES Pain scores , oral intake , and emesis on postoperative day ( POD ) 1 . RESULTS A total of 106 subjects ( 62 undergoing hot and 44 cold tonsillectomies ) received preoperative steroids , and 113 ( 56 hot and 57 cold tonsillectomies ) received placebo . On POD 1 , pain scores reported by patients ( P = .02 ) , parents ( P = .002 ) , and physicians ( P<.001 ) were significantly lower in subjects receiving steroids than in those receiving placebo .  Emesis was reduced from a mean of 2.1 ( placebo group ) to 1.2 episodes ( steroid group ) ( P = .02 ) . Oral intake improved from 24.5 % of normal diet ( placebo ) to 31.7 % ( steroid group ) ( P = .004 ) . When all 4 groups were compared ( cold placebo , cold steroid , hot placebo , and hot steroid ) , pain scores reported by physicians and parents were significantly lower in the cold steroid group than in the other groups . CONCLUSIONS Perioperative dexamethasone use reduces posttonsillectomy morbidity in pediatric patients in the early postoperative period after hot or cold tonsillectomy . The combination of steroid and cold dissection technique provided the greatest advantage in reducing posttonsillectomy subjective pain levels Edema contributes substantially to the postoperative discomfort and morbidity of adenotonsillectomy .  In a double-blind study , 58 children undergoing adenotonsillectomy were given a single intraoperative dose of either dexamethasone or saline . The steroid markedly affected the postoperative course in the first day after surgery . According to parental reports , the percentage of patients vomiting was reduced from 48 to 4 % . Severe throat pain was reported in 57 % of controls and only 20 % of dexamethasone patients . Twice as many steroid patients as controls tolerated some soft food on the first postoperative day . It appears that dexamethasone can greatly improve patient diet and comfort after adenotonsillectomy A prospect i ve , r and omized , double-blind study to determine the postoperative efficacy of steroids in tonsillectomy was performed in 49 children . A single dose of intravenous dexamethasone or placebo was administered after each child was anesthetized . Postoperatively each child was examined for objective signs of trismus ( measured by interincisor distance ) , temperature elevation , and weight loss , as well as for subjective signs of mouth odor , oral intake , pain , level of activity , and analgesic usage . There were no statistical differences noted in any of the variables compared in the two groups and the complication rates were also A prospect i ve , r and omized , double-blinded , placebo-controlled clinical trial was conducted in 41 patients evaluating the effect of a single preoperative dose of intravenous dexamethasone on postoperative vomiting and pain in children undergoing elective tonsillectomy .  Dexamethasone was found to significantly reduce the incidence of vomiting in the first 24 hours postoperatively ( P=0.02 ) , the time to first intake of solids ( P=0.001 ) , the need to administer a rescue antiemetic  ( P=0.005 ) and intravenous fluid therapy requirements ( P=0.006 ) in the postoperative period . No significant difference was found between the dexamethasone and placebo groups in the time to first intake of fluids , pain scores or analgesic requirement postoperatively . These results indicate that dexamethasone substantially reduces morbidity after tonsillectomy in children In this prospect i ve , r and omized , double-blind , placebo-controlled study , we examined the effect of preoperative dexamethasone on postoperative nausea and vomiting ( PONV ) and 24-h recovery in children undergoing tonsillectomy . One hundred thirty children , 2 - 12 yr of age , ASA physical status I or II , completed the study . All children received oral midazolam 0.5 - 0.6 mg/kg preoperatively . Anesthesia was induced with halothane and nitrous oxide in 60 % oxygen and maintained with nitrous oxide and isoflurane . Intubation was facilitated by mivacurium 0.2 mg/kg . Each child received fentanyl 1 [ micro sign]g/kg IV before initiation of surgery , as well as dexamethasone 1 mg/kg ( maximal dose 25 mg ) ( steroid group ) or an equal volume of saline ( control group ) . Intraoperative fluids were st and ardized to 25 - 30 mL/kg lactated Ringer 's solution . All tonsillectomies were performed under the supervision of one attending surgeon using an electrodissection technique . Postoperatively , fentanyl and acetaminophen with codeine elixir were administered as needed for pain . Rescue antiemetics were administered when a child experienced two episodes of retching and /or vomiting . Before home discharge , the incidence of PONV , need for rescue antiemetics , quality of oral intake , and analgesic requirements did not differ between groups . However , during the 24 h after discharge , more patients in the control group experienced PONV ( 62 % vs 24 % in the steroid group ) and complained of poor oral intake . Additionally , more children in the control group ( 8 % vs 0 % in the steroid group ) returned to the hospital for the management of PONV and /or poor oral intake . The preoperative administration of dexamethasone significantly decreased the incidence of PONV over the 24 h after home discharge in these children . Implication s : In this double blind , placebo-controlled study , we examined the efficacy of a single large dose ( 1 mg/kg ; maximal dose 25 mg ) of preoperative dexamethasone on posttonsillectomy postoperative nausea and vomiting ( PONV ) in children 2 - 12 yr of age undergoing tonsillectomy . Compared with placebo , dexamethasone significantly decreased the incidence of PONV in the 24 h after discharge , improved oral intake , decreased the frequency of parental phone calls , and result ed in no hospital returns for the management of PONV and /or poor oral intake . ( Anesth Analg 1998;87:57 - 61 BACKGROUND The minimum effective dose of dexamethasone in conjunction with 50 microg x kg(-1 ) ondansetron was evaluated in the treatment for vomiting after elective tonsillectomy or adenotonsillectomy . METHODS A total of 102 healthy children between 2 and 12 years of age participated in this prospect i ve , r and omized , double-blind study . A single intravenous ( i.v . ) dose of dexamethasone ( 50 , 100 , 150 microg x kg(-1 ) , maximum dose 8 mg ) with ondansetron ( 50 microg x kg(-1 ) ) was administered just before the end of surgery . Equal volumes of normal saline were given to the control group . General anaesthesia was induced and maintained by inhalation of N2O/O2 and sevoflurane . All other preoperative and postoperative medications ( including a supplementary dose of antiemetics if necessary ) , anaesthesia and surgical techniques were st and ardized . RESULTS No significant differences were observed between groups in postoperative vomiting on the day of surgery and the next day , or in the need for postoperative pain medication and supplementary doses of antiemetics ( P > 0.05 ) . CONCLUSIONS These results indicate that surgical technique and anaesthetic management used in this study could be the cause of the lower incidence of nausea and vomiting . Assessment of nausea and vomiting in a prospect i ve study with larger groups of patients may reflect different results OBJECTIVE To determine the effects of a single dose of dexamethasone sodium phosphate on postoperative morbidity in children undergoing tonsillectomy . DESIGN R and omized , double-blind , placebo-control clinical trial . SETTING Academic , tertiary care children 's hospital . PATIENTS Sixty-nine children ( 35 boys , 34 girls ) , aged 3 to 18 years , undergoing tonsillectomy with or without adenoidectomy .  INTERVENTION Patients were r and omized to receive a single dose of intravenous dexamethasone or saline . MAIN OUTCOME MEASURES Pain scores , determined by a Faces Scale , were obtained at 4-hour intervals during the first postoperative day and daily for 7 days thereafter . Total use of an analgesic ; type of diet ; level of activity ; presence of halitosis , nausea , emesis , or fever ; and incidence of postoperative bleeding were also compared between the two groups . RESULTS The two groups of children were similar in age , gender , diagnosis , and surgical time . Pain scores in the postoperative period were identical while the patients were in the hospital and for the first 7 days after discharge . No statistically significant differences were noted in pain scores , nausea , emesis , halitosis , analgesic medications required , diet , or activity levels between the two groups of patients . CONCLUSION A single intraoperative dose of dexamethasone did not appreciably affect postoperative morbidity in children undergoing tonsillectomy Purpose Previous studies on dexamethasone ’s antiemetic and analgesic potential in children undergoing tonsillectomy have produced conflicting results . The aim of this study was to evaluate the effects of a single dose of dexamethasone on the incidence and severity of postoperative vomiting and pain in children undergoing electrocautery tonsillectomy under st and ardized general anesthesia . Methods In a double-blinded study 120 patients were r and omly allocated to receive either dexamethasone 0.5 mg·kg−1 ( maximum dose 8 mg)iv or an equivalent volume of saline preoperatively . The incidence of early and late vomiting , need for rescue antiemetics , time to first oral intake , time to first dem and of analgesia and analgesic consumption were compared in both groups . Pain scores used included Children ’s Hospital Eastern Ontario Pain Scale , “ faces ” , and a 0–10 visual analogue pain scale . Results Compared with placebo , dexamethasone significantly decreased the incidence of early and late vomiting ( P < 0.05,P < 0.001 respectively ) . Fewer patients in the dexamethasone group needed antiemetic rescue ( P < 0.01 ) . The time to first oral intake was shorter , and the time to first dose of analgesic was longer in the dexamethasone group ( P < 0.01 ) . Pain scores 30 min after extubation were lower ( P < 0.05 ) in the dexamethasone group . At 12 and 24 hr postoperative swallowing was still significantly less painful in the dexamethasone group than in the control group ( P < 0.01 ) . Conclusion Preoperative dexamethasone 0.5 mg·kg−1iv reduced both postoperative vomiting and pain in children after electrocautery tonsillectomy . RésuméObjectifLes études antérieures sur le potentiel analgésique 
    Output:
    
: A single , intraoperative dose of dexamethasone may reduce post-tonsillectomy pain on postoperative day 1 , by a factor of 1 on a 10-point pain scale .