N P Parker1, D L Walner. 1. Department of Otolaryngology-Head and Neck Surgery, University of Minnesota Medical Center, Minneapolis, MN, USA.
Abstract
OBJECTIVE: To compare post-operative pain following tonsillectomy by either coblation or monopolar electrocautery in children. DESIGN: A parallel-designed, prospective, single-blinded, randomised trial. SETTING: Ambulatory surgical facility. STUDY PARTICIPANTS: Eighty otherwise healthy paediatric patients undergoing coblation or electrocautery tonsillectomy by a fellowship-trained paediatric otolaryngologist. MAIN OUTCOME MEASURES: (i) The number of post-operative days with severe pain based on subjective qualification by the caretaker, (ii) post-operative days with pain rated ≥ 5 on a scale of 1-10, (iii) post-operative days requiring oral paracetamol/acetaminophen with codeine solution and (iv) post-operative days until resumption of a regular diet were assessed and recorded daily using a post-operative pain survey as a form of daily diary that was returned at the 2-week follow-up visit. RESULTS:Patients were consecutively enrolled into two groups of 40 patients. Average ages were 5.2 years for coblation tonsillectomy and 6.0 years for electrocautery tonsillectomy. The average number of post-operative days with severe pain was 4.2 for coblation and 5.9 for electrocautery (P = 0.006), days rating pain ≥ 5 were 3.6 for coblation and 4.8 for electrocautery (P = 0.037), days of codeine use were 2.5 for coblation and 2.9 for electrocautery (P = 0.324), and days until resumption of a regular diet were 5.2 for coblation and 6.2 for electrocautery (0.329). CONCLUSIONS:Coblation tonsillectomy may reduce post-operative pain and the time until resumption of a regular diet compared to electrocautery tonsillectomy.
RCT Entities:
OBJECTIVE: To compare post-operative pain following tonsillectomy by either coblation or monopolar electrocautery in children. DESIGN: A parallel-designed, prospective, single-blinded, randomised trial. SETTING: Ambulatory surgical facility. STUDY PARTICIPANTS: Eighty otherwise healthy paediatric patients undergoing coblation or electrocautery tonsillectomy by a fellowship-trained paediatric otolaryngologist. MAIN OUTCOME MEASURES: (i) The number of post-operative days with severe pain based on subjective qualification by the caretaker, (ii) post-operative days with pain rated ≥ 5 on a scale of 1-10, (iii) post-operative days requiring oral paracetamol/acetaminophen with codeine solution and (iv) post-operative days until resumption of a regular diet were assessed and recorded daily using a post-operative pain survey as a form of daily diary that was returned at the 2-week follow-up visit. RESULTS:Patients were consecutively enrolled into two groups of 40 patients. Average ages were 5.2 years for coblation tonsillectomy and 6.0 years for electrocautery tonsillectomy. The average number of post-operative days with severe pain was 4.2 for coblation and 5.9 for electrocautery (P = 0.006), days rating pain ≥ 5 were 3.6 for coblation and 4.8 for electrocautery (P = 0.037), days of codeine use were 2.5 for coblation and 2.9 for electrocautery (P = 0.324), and days until resumption of a regular diet were 5.2 for coblation and 6.2 for electrocautery (0.329). CONCLUSIONS: Coblation tonsillectomy may reduce post-operative pain and the time until resumption of a regular diet compared to electrocautery tonsillectomy.
Authors: David O Francis; Christopher Fonnesbeck; Nila Sathe; Melissa McPheeters; Shanthi Krishnaswami; Sivakumar Chinnadurai Journal: Otolaryngol Head Neck Surg Date: 2017-01-17 Impact factor: 3.497