Comparison of Posttonsillectomy Pain Using the Ultrasonic Scalpel, Coblator, and Electrocautery

Parsons, Stephen P.; Cordes, Susan R.; Comer, Brett T.

doi:10.1016/j.otohns.2005.09.027

Cited by 132 publications

(169 citation statements)

References 18 publications

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“…In recent years, a few new tonsillectomy techniques such as harmonic ultrasonic knife, coblator, laser or radiofrequency excisions that aim to reduce bleeding, postoperative pain and operation time have been proposed. Parameters such as reducing post-tonsillectomy morbidity, pain and dehydration, preventing postoperative bleeding and providing adequate oral intake are crucial in surgical technique selection (Parsons et al, 2006). Unlike other studies, we performed cold technique and thermal welding method to each patient's right and left palatine tonsil, respectively by creating two groups of patients as more and younger than 12 years of age.…”

Section: Discussionmentioning

confidence: 99%

“…In a prospective randomized study conducted on adult patients by Parsons et al (2006), radiofrequency tonsillectomy has been reported to decrease postoperative pain compared to electro cautery. In a single-blind randomized study by Oko et al (2005) on pediatric patients, pain after tonsillectomy with blunt dissection was found to be significantly less than tonsillectomy with ultrasonic blades.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Cold Technique Tonsillectomy and Thermal Welding Tonsillectomy at Different Age Groups

et al. 2017

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26) Prague Medical Report / Vol. 118 (2017) Key words: Tonsillectomy -Thermal welding -Cold technique -Postoperative painAbstract: The aim of this study is to compare objectively advantages and disadvantages of cold technique tonsillectomy and thermal welding tonsillectomy at the same case. A total of 100 patients, 53 patients younger than 12 years of age and 47 patients elder than 12 years of age, were included in this study. Tonsillectomy was performed by using cold technique on the right side of the palatine tonsils and thermal welding on the left side. Right and left sides were compared regarding perioperative bleeding, surgical dissection time, postoperative pain scale at the 1 st and 7 th day and postoperative bleeding parameters. Perioperative bleeding was found to be higher in cold technique side in patients younger than 12 years of age (p<0.001). Postoperative pain score on the day 1 was significantly higher in cold technique side, whereas it was found to be higher in thermal welding side at postoperative day 7 (p<0.001). Perioperative bleeding was found to be significantly higher in cold technique side (p<0.001) and surgical dissection time of thermal welding was found to be longer (p<0.001) in patients elder than 12 years of age. Postoperative pain score at the day 1 and day 7 was found to be higher in thermal welding side (p<0.001). Postoperative pain score at the day 1 and day 7 were statistically significantly higher in patients elder than 12 years of age. As a result, both techniques have its unique superior aspects and both can be applied as a routine tonsillectomy technique.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of Cold Technique Tonsillectomy and Thermal Welding Tonsillectomy at Different Age Groups

et al. 2017

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“…However, there is not any such instrument causing total reduction of bleeding and pain. 3,4 Certainly, otolaryngologists would want to investigate the feasibility of any new instrumentation that would decrease the morbidity of tonsillectomy, even if it were relatively expensive.…”

Section: Introductionmentioning

confidence: 99%

Thunderbeat versus bipolar diathermy in surgical outcome of tonsillectomy

2018

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Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for the different indications. There are different studies in literature comparing bipolar diathermy with either harmonic scalpel or cold dissection but the thunderbeat is still not used in tonsillectomy. The thunderbeat device which is the integration of ultrasonic and advanced bipolar energies used exclusively in laparoscopic surgery but still not used in tonsillectomy. So, the main aim of this study is to compare the thunderbeat device with bipolar diathermy in surgical outcome of tonsillectomy.Methods: This was the prospective study performed in total 25 patients. The patients included in the study underwent tonsillectomy on one side using thunderbeat device and on the other side using bipolar diathermy. The intra-operative blood loss, operative time and post-operative pain were taken for analysis in both the surgical procedures. All the data were analyzed with the statistical package for the social sciences (SPSS) software version 20. Results: Among the twenty five patients, the age groups range from 19-36 years with mean age 25.36±5.62 years. Out of 25 patients, 7 were male and 18 were female. The comparison of operation time and intra-operative blood loss between thunderbeat and bipolar diathermy showed statistically significant differences. The comparison of pain score showed statistically significant result with better pain results in bipolar diathermy.Conclusions: The thunderbeat uses in tonsillectomies is less time consuming and decrease intra-operative blood loss. But, the post-operative pain is more as compared to bipolar diathermy. Though, it is safe and effective in performing tonsillectomy but its cost is the main drawback for its regular use.

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“…Recently, ultrasonic instruments such as the Harmonic scalpel and Coblator have also been introduced. [1][2][3] Since, these ultrasonic instruments are operated at lower temperatures (60-100 o C) than conventional bipolar electrocautery (150-400 o C), it is thought that postoperative pain is likely reduced. 4 However, the efficacy of ultrasonic devices for tonsillectomy is still debatable, although those devices have been reported to induce fewer complications if the expert surgeon uses such instruments with appropriate caution.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Efficacy of 1940-nm Diode Laser in Tonsillectomy: Preliminary Report

Lee

Cho

et al. 2015

Medical Lasers

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Background and ObjectivesThe aim of this clinical feasibility study was to assess preliminary results regarding postoperative outcomes of tonsillectomy using a laser system emitting at 1940 nm. Materials and MethodsThis clinical feasibility trial included six patients suffering from chronic tonsillitis. Tonsillectomy was performed using a 1940 nm laser with 6 W of output power. Intraoperative scoring was performed by a surgeon rating the cutting capacity of the device (5 point scale, 1-5), as well as intraoperative bleeding (3 point scale, 0-2). Patient surveys of pain and the surgeon's reports on postoperative changes in the surgical field (11 point scale, 0-10) were also analyzed on postoperative day one, and after week(s) one and two. ResultsNo complications were observed in patients. The surgeon's mean rating on the cutting capacity of the laser was 4.33 ± 1.96. Bleeding was almost absent, with a mean blood loss of 2.3 ml. Postoperative pain abruptly decreased after postoperative week one (4.83 ± 2.23, 3.33 ± 2.65, 1.17 ± 0.75 at postoperative day one, week one, and week two, respectively), with a statistically significant difference observed between postoperative day one and week two (p=0.008). Two patients required additional pain relief for five days after postoperative week one. Swelling had decreased significantly by postoperative week one (p=0.004), with a score of nearly 0 by postoperative week two. The mean scores for changes in scarring were 4.83 ± 0.40, 2.83 ± 1.21, and 1.67 ± 2.07 at postoperative day one, week one, and week two. ConclusionA 1940 nm laser demonstrated excellent intraoperative performances and postoperative outcomes in tonsillectomy. In addition, conduct of more large-scale and comparative studies is warranted in order to elucidate the efficacy of this laser treatment for tonsillectomy. Key words

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Comparison of Posttonsillectomy Pain Using the Ultrasonic Scalpel, Coblator, and Electrocautery

Abstract: A-1b.

Cited by 132 publications

References 18 publications

Comparison of Cold Technique Tonsillectomy and Thermal Welding Tonsillectomy at Different Age Groups

Comparison of Cold Technique Tonsillectomy and Thermal Welding Tonsillectomy at Different Age Groups

Thunderbeat versus bipolar diathermy in surgical outcome of tonsillectomy

Evaluation of the Efficacy of 1940-nm Diode Laser in Tonsillectomy: Preliminary Report

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