Randomized study comparing postoperative pain between coblation and bipolar scissor tonsillectomy

Abstract

Coblation tonsillectomy has shown promising results with respect to postoperative pain when compared with other techniques. Our study was designed to compare this technique with bipolar scissor tonsillectomy. Forty adult patients with a history of chronic or recurrent tonsillitis referred for standard tonsillectomy were recruited and randomized into two groups. Twenty were operated with Coblator and 20 with bipolar scissors. Exclusion criteria were a history of quinsy, bleeding disorder, or any major health problems. All participants completed the study. Postoperative pain, return to normal diet, and estimated need for sick leave were utilized as parameters. Data on operative time, difficulty of tissue removal, and hemostasis were also analyzed. Operative time was longer (P < 0.001) and tissue removal as well as hemostasis control were more difficult (P = 0.005, P = 0.013) with Coblator than with bipolar scissors. Participants in Coblator group assessed higher pain scores 1 and 3 h postoperatively (P = 0.044, P = 0.036). From the time of extubation, patients had access to an opioid (fentanyl) via a self-controlled analgesia device. The number of doses of analgesics needed during the hospital stay was significantly higher in the Coblator group (P = 0.020). During the 14-day follow-up, no significant differences were found in pain scores, return to solid food or subjective working ability between the groups. Considering the overall outcome of the patients the results did not favor coblation technique over bipolar scissors.

Comparison of post-tonsillectomy pain with two different types of bipolar forceps: Low temperature quantum molecular resonance device versus high temperature conventional electrocautery

“…After the introduction of radiofrequency devices such as the Harmonic scalpel and Coblator, one report showed that the Coblator was superior to the Harmonic scalpel and electrocautery [3]. One study revealed that bipolar scissors were better than the Coblator in the aspect of pain [15]. Tonsillectomy using the Harmonic scalpel did not show consistent favorable results [16,17].…”

Comparing Traditional Cold Knife Tonsillectomy with a New Technique Plasma Knife Tonsillectomy

“…Return to normal activity time is reported later by Hasan et al (9) and earlier by Di Rienzo et al (8) in the PKT group. In Figure 1.…”

“…Di Rienzo et al (8) reported less intraoperative blood loss in the PKT group where as Hasan et al (9) found more blood loss in the PKT group. In our study we observed less intraoperative blood loss in the PKT group.…”

Is the systemic inflammatory reaction to surgery responsible for post-operative pain after tonsillectomy, and is it "technique-related"?

“…As has been found by the technique pioneers, Timms and Temple, as well as by Hasan et al and Roje et al, children and adults who were operated on by coblation suff ered statistically signifi cantly less postoperative pain and experienced a considerably faster return to normal dietary habits [68, 15,22]. Stoker et al have demonstrated that radiofrequency tonsillectomy is superior to diathermy in terms of reduced postoperative pain, local edema, and faster wound healing [11].…”