Background: Tonsillectomy is one of the most commonly performed operations in otolaryngology. There are many proven methods of tonsillectomy, including cold dissection and bipolar electrocautery. Objective: To compare bipolar elecrocautery tonsillectomy with cold dissection method in pediatric age groups. Methods: Single blind controlled study to compare bipolar technique against the conventional dissection/snare technique. Results: The average amount of bleeding on electrocautery side was 4.07ml and on the cold dissection side was 14.58 ml. The mean time of operation for electrocautery and cold dissection was 12.04 and 16.57 minutes respectively. On the second post operative day, 35% of the patients complained of pain on the cauterized side, 30% complained of more pain on the dissection side while 35 % experienced equal pain on both sides. Post-operative complication such as hemorrhage was not seen in both the techniques employed. Conclusion: In the present study, bipolar diathermy tonsillectomy had advantages in having less post-operative time and blood loss intraoperatively but patients experience slightly more pain than cold dissection.
Background: Packs are placed following nasal surgeries to arrest haemorrhage, to prevent septal haematoma and synechie formation. Despite Merocel, a tampon constructed from a foam polymer of hydroxylated polyvinyl acetate, which is less abrasive and hence associated with the less pain, we still use Neosporine Impregnated Ribbon Gauze (NIRG). Objective: To compare Merocel and the Neosporine Impregnated Ribbon gauze (NIRG) packs in regards to the post-operative pain levels caused by them and their ability to prevent haemorrhage, crusting and synechie. Methods: The nose was packed after surgery either with the Merocel pack or Neosporin Impregnated Ribbon Gauze (NIRG) according to the randomisation. The pain score was noted on the Visual analog score while packs were in situ and again immediately after the pack removal. The haemorrhage, crusting and synechie were noted if present. Results: Among 106 patients, 61 were male and 45 were female. In Merocel group there were 51 patients and in NIRG group 55. The mean pain score for merocel was 4.15 while in situ and 3.66 immediately after removal where as mean pain score for NIRG was 6 while in situ and 3.78 immediately after removals. Post-operative crusting and synechie were seen relatively more in NIRG pack group. Conclusion: Merocel is superior in terms of both patient comfort and pain. DOI: http://dx.doi.org/10.3126/hren.v10i1.6004 HREN 2012; 10(1): 30-34
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