Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel: a randomised blinded study

Arbin, Linn; Enlund, Mats; Knutsson, Johan

doi:10.1007/s00405-017-4451-9

Cited by 24 publications

(33 citation statements)

References 19 publications

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“…1 Multiple surgical techniques and instruments have been described to minimize intraoperative hemorrhage and reduce the operation time, postoperative pain, and incidence of comorbidities in patients undergoing tonsillectomy. 2,3 Coblation tonsillectomy has been shown to induce less postoperative pain, intraoperative hemorrhage, and surgical trauma and to provide quick recovery and a short hospitalization time. 4 Coblation is a technique that utilizes bipolar radiofrequency energy for soft tissue dissolution.…”

Section: Introductionmentioning

confidence: 99%

Coblation tonsillectomy versus coblation tonsillectomy with ties in adults

Zhou

Zhen

et al. 2019

J Int Med Res

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Objective This study was performed to compare the intraoperative and postoperative courses of coblation tonsillectomy and coblation tonsillectomy with ties in adults. Methods All patients who underwent tonsillectomy from July 2012 to September 2016 were retrospectively reviewed. Intraoperative and postoperative bleeding, pain, and return to normal food intake were compared between patients who underwent coblation tonsillectomy and those who underwent coblation tonsillectomy with ties. Results Of 515 patients, 300 (58.3%) underwent coblation tonsillectomy and 215 (41.7%) underwent coblation tonsillectomy with ties. Twenty-five (4.9%) patients developed postoperative hemorrhage, 22 (88.0%) of whom had undergone coblation tonsillectomy and 3 (12.0%) of whom had undergone coblation tonsillectomy with ties. Patients who underwent coblation tonsillectomy reported less pain than those who underwent coblation tonsillectomy with ties. Patients who underwent coblation tonsillectomy with ties resumed a normal diet significantly later than those who underwent coblation tonsillectomy (10.0 ± 3.2 vs. 8.2 ± 1.9 days, respectively). Conclusion Coblation tonsillectomy is associated with less intraoperative bleeding, a shorter surgery time, less postoperative pain, and fewer days to recovery of a normal diet than is coblation tonsillectomy with ties. However, coblation tonsillectomy with ties is associated with remarkably reduced postoperative hemorrhage.

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Section: Introductionmentioning

confidence: 99%

Coblation tonsillectomy versus coblation tonsillectomy with ties in adults

Zhou

Zhen

et al. 2019

J Int Med Res

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“…Consequently, glossopharyngeal nerve block resulted in decreased postoperative pain after tonsillectomy and decreased analgesic consumption. The control of postoperative pain following adeno-tonsillectomy resulted in decreased morbidity and increased satisfaction (3, 11).…”

Section: Discussionmentioning

confidence: 99%

“…Other mediators, such as prostaglandins, increase the sensitivity of nociceptive receptors to other mediators. Thus, increased inflammation is associated with increased postoperative pain and discomfort, especially during the first postoperative day (3, 4).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Glossopharyngeal Nerve Block on Post-Tonsillectomy Pain of Children; Randomized Controlled Trial

Ahmed

Omara

2019

Anesth Pain Med

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Background Sensory fibers of the glossopharyngeal nerve supply the tonsillar and peritonsillar areas. Thus, bilateral glossopharyngeal nerve block may alleviate post-tonsillectomy pain and improve postoperative analgesia. Objectives The purpose of this clinical trial was to evaluate the effect of glossopharyngeal nerve block on postoperative analgesia in children undergoing adeno-tonsillectomy Methods Ninety ASA I-II pediatric patients presented for adeno-tonsillectomy were included in this trial. They were equally divided and randomly assigned to one of two groups: A control group, in which children did not receive a nerve block, and a glossopharyngeal nerve block group, in which children received bilateral glossopharyngeal nerve block after surgery. The postoperative pain score (FLACC score) during rest and swallowing, the time for the first request for rescue analgesia, the total dose consumption of pethidine rescue analgesia, and the incidence of postoperative complications were all assessed. Moreover, response to gag reflex, degree of difficulty in swallowing, and parents’ satisfaction were recorded. Results Bilateral glossopharyngeal nerve block in children presented for adeno-tonsillectomy significantly prolonged the time for the first request of rescue analgesia, compared to the control group, reaching 5.833 ± 2.667 hours (P < 0.0001). It also decreased postoperative pethidine consumption to 0.878 ± 0.387 mg/kg (P = 0.0009). Moreover, it significantly decreased the postoperative FLACC score assessed two, four, six, and twelve hours after surgery, during rest and swallowing (P < 0.05). The response to gag reflex and difficulty in swallowing were also significantly decreased (P ≤ 0.0001 and 0.006, respectively). In addition, glossopharyngeal nerve block significantly increased parents’ satisfaction (P = 0.0002), with no significant increase in the incidence of postoperative complications (P > 0.05). Conclusions Bilateral glossopharyngeal nerve block in children undergoing adeno-tonsillectomy improved the duration and the quality of postoperative analgesia, decreased swallowing difficulties, and improved parents’ satisfaction.

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“…Alexiou et al [14] have concluded that harmonic scalpel techniques do not provide any significant advantage compared to cold dissection or electrocautery with respect to postoperative pain in their meta-analysis of randomized controlled trials. Arbin et al [15] have also suggested that the usage of harmonic scalpel does not render less postoperative pain following tonsillectomy when compared with the usage of bipolar diathermy scissors.…”

Section: Harmonic Scalpelmentioning

confidence: 99%