A randomised controlled trial to compare postoperative pain in children undergoing tonsillectomy using cold steel dissection with bipolar haemostasis versus coblation technique

Parker, David A.; Howe, L; Unsworth, Vanessa; Hilliam, Rachel

doi:10.1111/j.1749-4486.2009.01932.x

Cited by 37 publications

(43 citation statements)

References 16 publications

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“…On comparing the pain scores in the immediate postoperative evening after 06 hours of surgery there was no statistically difference in the pain scores between the two groups as shown in Table 1. These findings were in consonance with other authors such as Shah, Magdy & Parker D. 5,7,13 In our study there was no statistical difference in the pain score on the first postoperative day between the 2 groups however on the 7 th postoperative day the pain score was more for the coblation arm and it was statistically significant as in Table 1. In our study we found that the postoperative pain is equal on both sides in the early period whereas in the later postoperative period, cold steel provides better pain relief than coblation technique.…”

Section: Discussionsupporting

confidence: 93%

A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

Nithya

Dutta

Sabarigirish

2016

Int J Otorhinolaryngol Head Neck Surg

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Background: The aim of the present study was to compare intraoperative blood loss, operative duration and postoperative pain between coblation-assisted adenotonsillectomy and cold dissection adenotonsillectomy in children.Methods: A prospective, randomized, single-blind trial of pediatric patients aged 7 to 13 years undergoing adenotonsillectomy was conducted. Patients were randomized to undergo either cold dissection or coblation-assisted adenotonsillectomy. Measured intraoperative parameters included surgical duration and intraoperative blood loss. Measured postoperative parameters included a daily pain rating using the visual analog scale on the postoperative evening, postoperative day 1 and day 7. Intraoperative and postoperative measures were statistically compared between the two groups. Results: Sixty children were randomized and included in the study. 30 patients underwent cold dissection adenotonsillectomy and 30 coblation-assisted adenotonsillectomy. Mean age was 8.7 years in the coblation group and 9.1 years in the cold dissection group. Intraoperative blood loss was lower for the coblation assisted adenotonsillectomy group versus the cold dissection adenotonsillectomy group which was proved statistically (mean bleeding was 16.67 in coblation group and 58.67 in cold dissection group and p value <0.0001).There was statistically no significant difference in the mean pain scores in the 2 groups in the postoperative evening and on postoperative day 1. The mean pain scores on postoperative day 7 were found to be 3.4 in the coblation group and 2.47 in the cold dissection group with a significant p value of 0.0087. The average duration of surgery in the coblation group was 55.6 minutes as against 34.1 minutes in the cold dissection group. The p- value was found to be less than 0.0001 which makes the difference statistically significant. Conclusions: This study found that the intraoperative blood loss was significantly less in Coblation adenotonsillectomy than in cold dissection adenotonsillectomy. The duration of surgery in Coblation assisted adenotonsillectomy is significantly greater than the duration of surgery in cold dissectionadenotonsillectomy. While the postoperative pain scores are similar with coblation and cold dissection adenotonsillectomy in the early postoperative period, it is significantly more with coblation in the late postoperative period.

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Section: Discussionsupporting

confidence: 93%

A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

Nithya

Dutta

Sabarigirish

2016

Int J Otorhinolaryngol Head Neck Surg

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“…12 Shapiro and Bhattacharryya (2007) compared the intraoperative efficiency and postoperative recovery between dissection and coblation tonsillectomy (age 2-16) over 14 postoperative days, including the day of operation, found that there was no statistically significant difference in the mean pain scores between two procedures and this result is similar to the result of our study. 15 In another study done by Parker et al (2009), with respect to postoperative pain and return to normal diet, he discovered that coblation did not offer the significant advantage over dissection method. 9 In addition, another study done by Businco & Tirelli (2011), showed that the day of pain-free was 4.8 vs. 9.4 for dissection, also coblation group stopped liquid diet sooner (day 5 vs. day 9) and lost fewer school days than dissection children.…”

Section: Resultsmentioning

confidence: 99%

“…15 In another study done by Parker et al (2009), with respect to postoperative pain and return to normal diet, he discovered that coblation did not offer the significant advantage over dissection method. 9 In addition, another study done by Businco & Tirelli (2011), showed that the day of pain-free was 4.8 vs. 9.4 for dissection, also coblation group stopped liquid diet sooner (day 5 vs. day 9) and lost fewer school days than dissection children. 3 Roje et al (2009) did a comparison study between the two techniques; he revealed that children operated on by coblation technique faster resumed normal physical activities in 2 vs. 4 days and the result was statistically significant.…”

Section: Resultsmentioning

confidence: 99%

“…Operations performed by the same surgeon. Results: The intraoperative time was significantly shorter (P <0.001) and intraoperative blood loss was significantly lesser (P <00.01) in coblation as compared to dissection tonsillectomy, while there were no significant differences in the postoperative pain scores on 1 8,9 A new technique for tonsillectomy should be comparable to, or better than existing techniques in the areas of morbidity and mortality, be safe to use, have a short learning curve, and be cost effective. In particular, it preferably would be associated with less postoperative pain, less intraoperative blood loss, allow the most rapid return to normal diet and activity and carry a lower risk of both reactive and secondary hemorrhage.…”

Section: Introductionmentioning

confidence: 98%

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Coblation versus dissection tonsillectomy in children

Tahyr

Yaseen

2018

ZJMS

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“…Peritonsillar infiltration of different types of drugs in children undergoing adenotonsillectomy has been cited many times during the past years, using local anesthetics [4], opioids [5,6], corticosteroids [7][8][9], ketamine [10,11], gabapentine [12] and even non-pharmacologic interventions [13] as adjuvant local analgesic compounds.…”

Section: Introductionmentioning

confidence: 99%

Rectal acetaminophen versus peritonsillar infiltration of bupivacaine for postoperative analgesia after adenotonsillectomy in children

Dahi-Taleghani

Mousavifard

Tahmoureszade

et al. 2010

Eur Arch Otorhinolaryngol

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There are a wide range of analgesic methods used for postoperative pain control in children undergoing elective adenotonsillectomy and there are many cases in which the postoperative analgesic modalities have not been fully successful to treat pain effectively. The acute postoperative analgesic effects of peritonsillar bupivacaine infiltration compared with rectal acetaminophen suppositories in elective adenotonsillectomy have been compared here. The methods employed were a single blind randomized clinical trail where 110 cases were selected to enter the study. After induction of anesthesia and intubation, and just before start of the procedure, the 1st group received 30 mg/kg of acetaminophen rectally; while, the 2nd group received 1 mg/kg peritonsillar bupivacaine infiltration around the tonsils. Throat pain at rest, after swallowing, after taking fluid and after soft food and also, parents' and nurses satisfaction regarding patient analgesia were compared. The results stated that there was no difference between the two groups regarding throat pain at rest, after swallowing, after taking fluid and after soft food and also, parents' and nurses' satisfaction. We concluded that when considering the feasibility of rectal acetaminophen, the results of the study suggest it superior due to minimal risks compared with local peritonsillar administration of bupivacaine for elective adenotonsillectomy of children.

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A randomised controlled trial to compare postoperative pain in children undergoing tonsillectomy using cold steel dissection with bipolar haemostasis versus coblation technique

Abstract: The findings do not confirm the hypothesis that tonsillectomy undertaken in children, with the coblator device, is associated with lower levels of postoperative pain, but do indicate that less analgesia is required by the coblator patients in the first 12 h postoperatively.

Cited by 37 publications

References 16 publications

A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

Coblation versus dissection tonsillectomy in children

Rectal acetaminophen versus peritonsillar infiltration of bupivacaine for postoperative analgesia after adenotonsillectomy in children

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