DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20205004

Comparison of post operative pain in tonsillectomy: a three year prospective study

Akshay Jain, Smruti Milan Tripathy

Abstract


Background: Tonsillectomy is the oldest surgery performed by otorhinolaryngologists worldwide. Through ages different techniques have been tried to improve the post surgical outcome and reduce morbidity among patients. Aim of the current study was to compare the post-operative pain among the patients undergoing tonsillectomy by cold dissection, bipolar cautery dissection and coblation dissection.

Methods: 142 Patients undergoing tonsillectomy in ENT department of TMMC during the period of 3 year were included in the study. Patients were randomly distributed to undergo different techniques of tonsillectomy. The post-operative pain in patients was assessed using the pre-standardized visual analogue pain scale and results were analyzed.

Results: No statistically significant difference was found among the groups undergoing tonsillectomy by cold dissection, bipolar dissection and coblator dissection as the p>0.05. The immediate post-operative pain was found to be slightly higher among the group undergoing tonsillectomy by coblator dissection and the analgesics dose needed in the post-operative period remained the same for all for patients of all the three groups.

Conclusions: No statistically significant difference was found in the post-operative pain scores of patients undergoing tonsillectomy by CD, BD and CBD techniques.


Keywords


Tonsillectomy, Post-operative pain, Analgesics, VAS score

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References


Young J, Bennett J. History of tonsillectomy. ENT News. 2004;13:34-5.

Curtin J. The history of tonsil and adenoid surgery. Otolaryngol Clin North Am. 1987;20:415-9.

Worthington TC. A simple method of excision of the faucial tonsil. JAMA. 1907;48:1761-2.

Haase FR, Noguera JT. Hemostasis in tonsillectomy by electro-cautery. Arch Otolaryngol. 1962;75:125-6.

Pang Y. Paediatric tonsillectomy: bipolar electro-dissection and dissection/snare compared. J Laryngol Otol. 1995;109:733-6.

McGuire NG. A method of guillotine tonsillectomy with an historical review. J Laryngol Otol. 1967;81:187-95.

Weingarten C. Ultrasonic tonsillectomy: rationale and technique. Otolaryngol Head Neck Surg. 1197;116:193-6.

Martinez SA, Akin DP. Laser tonsillectomy and adenoidectomy. Otolaryngol Clin North Am. 1990;20:371-6.

Saleh HA, Cain AJ, Mountain, RE. Bipolar scissor tonsillectomy. Clin Otolaryngol Allied Sci. 1999;24:9-12.

Sobol SE, Wetmore RF, Marsh RR, Stow J, Jacobs IN. Postoperative recovery after microdebrider intracapsular or monopolar electrocautery tonsillectomy: a prospective, randomized, single-blinded study. Arch Otolaryngol Head Neck Surg. 2006;132(3):270-4.

Woloszko J, Gilbride C. Coblation technology: plasma meditation ablation for otolaryngology applications. Available at: https://ui.adsabs.harvard. edu/abs/2000SPIE.3907..306W/abstract. Accessed on 20 September 2020.

Warnock FF, Lander J. Pain progression, intensity and outcomes following tonsillectomy. Pain. 1998; 75(1):37-45.

Plant RL. Radiofrequency treatment of tonsillar hypertrophy. La¬ryngoscope. 2002;112(suppl 100): 20-2.

Belloso A, Chidambaram A, Morar P, Timms MS. Coblation tonsil¬lectomy versus dissection tonsillectomy: postoperative hemorrhage. Laryngoscope. 2003;113(11):2010-3.

Burton MJ, Doree C. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev. 2007;(3):CD004619.

Silveira H, Soares JS, Lima HA. Tonsillectomy: cold dissectionversus bipolar electrodissection. Int J Pediatr Otorhinolaryngol. 2003;67:345-51.

Adoga A. Cold versus hot dissection tonsillec-tomies: the Nigerian experience. ASEA. 2011;16: 64-8.

Mofatteh MR, Salehi F, Hosseini M, Hassanzadeh-Taheri M, Sharifzadeh G, Hassanzadeh-Taheri M. Comparison of postoperative morbidity between conventional cold dissection and bipolar electrocautery tonsillectomy: which technique is better?. Braz J Otorhinolaryngol. 2020;86(4):427-33.

Parker D, Howe L, Unsworth V, Hilliam R. A randomised controlled trial to compare postoperative pain in children undergoing tonsillec¬tomy using cold steel dissection with bipolar haemostasis versus co¬blation technique. Clin Otolaryngol. 2009;34(3):225-31.

Hong SM, Cho JG, Chae SW, Lee HM, Woo JS. Coblation vs. Electrocautery Tonsillectomy: A Prospective Randomized Study Comparing Clinical Outcomes in Adolescents and Adults. Clin Exp Otorhinolaryngol. 2013;6(2):90-3.

Stoker KE, Don DM, Kang DR, Haupert MS, Magit A, Madgy DN. Pediatric total tonsillectomy using coblation compared to conven¬tional electrosurgery: a prospective, controlled single-blind study. Otolaryngol Head Neck Surg. 2004;130(6):666-75.

Parsons SP, Cordes SR, Comer B. Comparison of post tonsillectomy pain using the ultrasonic scalpel, coblator, and electrocautery. Oto¬laryngol Head Neck Surg. 2006;134(1):106-13.

Polites N, Joniau S, Wabnitz D, Fassina R, Smythe C, Varley P, et al. Postoperative pain following coblation tonsillectomy: randomized clinical trial. ANZ J Surg. 2006;76(4):226-9.