Post-operative morbidity following paediatric tonsillectomy; a comparison of bipolar diathermy dissection and blunt dissection.

In a prospective study of 76 children aged between 18 months and 13 years, 40 children underwent tonsillectomy using the traditional blunt dissection technique with bipolar diathermy to establish haemostasis while 36 children underwent tonsillectomy where bipolar diathermy alone was used to dissect out the tonsils. Blood loss was significantly reduced in the diathermy dissection group (10.5 ml +/- 2.05, diathermy dissection, 33.56 ml +/- 1.95, blunt dissection, P < 0.05). More analgesia was required in the diathermy dissection group prior to hospital discharge (P = 0.01). The diathermy dissection group took a significantly longer period of time to re-establish a normal diet (7.07 days +/- 0.44, diathermy dissection, 5.15 days +/- 0.36, blunt dissection, P = 0.001). Fifteen percent of children in the blunt dissection group and 31% in the diathermy dissection group were taken to the general practitioner between days 3-10 because of sore throat, poor oral intake or otalgia. Twenty two point four percent of children overall were prescribed antibiotics. This recently described technique of bipolar diathermy dissection could be a useful technique in selected cases such as the very small or those with a bleeding diathesis but is associated with increased postoperative morbidity and requires good postoperative analgesia.