{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T03:54:53Z","timestamp":1784865293605,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare postoperative caregiver\u2010reported pain control of two steroid regimens following pediatric adenotonsillectomy. Secondary objectives assessed differences in analgesic use, return to normal diet, caregiver calls, adverse effects, and emergency room (ER) visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective randomized pragmatic trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Three academic tertiary care children's hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Healthy children aged 3 to 10 undergoing adenotonsillectomy were recruited and randomly assigned to receive either 0.6\u2009mg\/kg dexamethasone on postoperative day 3 or prednisolone 0.5\u2009mg\/kg days 1 to 3. Both groups continued standard weight\u2010based regimens of acetaminophen and ibuprofen. A blinded research team member performed postoperative telephone surveys using the Wong\u2010Baker FACES pain\u2010rating scale. Secondary outcomes were reviewed using a combination of a telephone survey and electronic health record review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 119 patients were randomly assigned (61 [51%] female, 58 [49%] male, and mean age of 5.8 years (95% CI, 5.5\u20106.2), with 59 (49.6%) in the dexamethasone group and 60 (50.4%) in the prednisolone group. The pain score was lower in the prednisolone group (4.0 [3.7\u20104.3]) in the univariate model. However adjustment for covariates and random effects mitigated this difference (<jats:italic>b<\/jats:italic>\u2009=\u20090.00; 95% CI, \u22120.52 to 0.52; <jats:italic>P<\/jats:italic>\u2009=\u2009.99). There were no significant differences in analgesic use, return to normal diet, calls, adverse effects, or ER visits. There were no subgroup effects related to surgical technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prednisolone and dexamethasone\u2010based regimens show comparable efficacy for pain scores, return to diet and resumption of activities with no reported adverse events. Shared decision\u2010making should involve caregivers to select the regimen best suited for their child's circumstances.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1318","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T07:48:38Z","timestamp":1747986518000},"page":"636-644","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Steroids for Pediatric Adenotonsillectomy Pain\u2014A Prospective Multicenter Randomized Trial"],"prefix":"10.1002","volume":"173","author":[{"given":"Kevin D.","family":"Pereira","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Department of Pediatrics University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8894-8047","authenticated-orcid":false,"given":"Wiktoria A.","family":"Gocal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna V.","family":"Borodianski","sequence":"additional","affiliation":[{"name":"Children's National Medical Center, Division of Otolaryngology Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hengameh K.","family":"Behzadpour","sequence":"additional","affiliation":[{"name":"Children's National Medical Center, Division of Otolaryngology Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonal","family":"Saraiya","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego A.","family":"Preciado","sequence":"additional","affiliation":[{"name":"Children's National Medical Center, Division of Otolaryngology Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Isaiah","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Department of Pediatrics University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Department of Diagnostic Radiology and Nuclear Medicine University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"University of Maryland Institute for Health Computing Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Healthcare Cost and Utilization Project (HCUP) Statistical Briefs","author":"McDermott KW","year":"2006"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1884"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.11.009"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812447776"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000024122"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818801757"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12974"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.237"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24958"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200012000-00003"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27167"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820973250"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200544010-00003"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(77)90233-9"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2003.25"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0021-75572007000700007"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000251"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.01.034"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e31827b2299"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2009.00620.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","unstructured":"BatesD M\u00e4chlerM BolkerB WalkerS. 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