Evaluating postoperative pain in monopolar cautery versus harmonic scalpel tonsillectomy
Presented at the Canadian Society of Otolaryngology Head and Neck Surgery Meeting, Kelowna, British Columbia, Canada, May 2006.
Received 7 April 2009; received in revised form 25 July 2009; accepted 20 August 2009. published online 28 October 2009.
Abstract
Objectives
To compare postoperative pain between monopolar cautery tonsillectomy and harmonic scalpel tonsillectomy (HST).
Study Design
Randomized controlled trial using paired organs.
Setting
Community hospital with academic affiliation.
Subjects
One hundred and fourteen consecutive patients six years of age or older undergoing tonsillectomy for indications of hypertrophy or recurrent infection.
Methods
For each subject, monopolar cautery tonsillectomy was performed by four senior surgeons on one side and HST was performed on the other side. Allocation of technique to side was randomized and revealed to the surgeon at the start of the operation. Validated visual analog pain scales were used to quantify pain at rest and with swallowing for each side and were completed daily for 14 days. All subjects were prescribed weight-equivalent doses of analgesics. Secondary outcome measures included postoperative complications (hemorrhage and readmission).
Results
Pairwise comparisons of pain scores revealed no significant difference between monopolar cautery tonsillectomy and HST (P < 0.05).
Conclusions
Subjects undergoing monopolar cautery tonsillectomy do not experience increased postoperative pain in comparison to HST.
aDepartment of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
bDepartment of Otolaryngology–Head and Neck Surgery, Toronto East General Hospital, Toronto, Ontario, Canada
Corresponding author: Sharon L. Cushing, MD, MSc, Department of Otolaryngology–Head and Neck Surgery, University of Toronto, UHN-TGH, 190 Elizabeth St., RFE 3S-438, Toronto, ON, Canada M5G 2N2
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
ABSTRACT