Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-07-02T19:49:54.617Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of diathermy on pain and healing in tonsillectomy, compared with other methods of haemostasis: a randomised study

Published online by Cambridge University Press:  10 October 2008

C H Hahn ,
J A Rungby ,
T Overgaard ,
H Møller ,
P Schultz  and
M Tos
C H Hahn*
Affiliation:
Department of Otorhinolaryngology, University of Copenhagen, Gentofte Hospital, Copenhagen, Denmark
J A Rungby
Affiliation:
Department of Otorhinolaryngology, University of Copenhagen, Gentofte Hospital, Copenhagen, Denmark
T Overgaard
Affiliation:
Department of Otorhinolaryngology, University of Copenhagen, Gentofte Hospital, Copenhagen, Denmark
H Møller
Affiliation:
Department of Otorhinolaryngology, University of Copenhagen, Gentofte Hospital, Copenhagen, Denmark
P Schultz
Affiliation:
Department of Otorhinolaryngology, University of Copenhagen, Gentofte Hospital, Copenhagen, Denmark
M Tos
Affiliation:
Department of Otorhinolaryngology, University of Copenhagen, Gentofte Hospital, Copenhagen, Denmark
*
Address for correspondence: Dr Christoffer Holst Hahn, Gjorslevvej 14, DK – 2720 Vanløse, Denmark. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To compare three methods of haemostasis used for ‘cold steel’ tonsillectomy, in terms of pain scores and morbidity.

Method and material:

Prospective, randomised, single-blinded, controlled clinical study. Three haemostasis methods were compared: compression of the tonsillar fossae with gauze packs; bipolar diathermy; and local anaesthesia then pack compression. The outcome measures were pain scores (derived from a visual analogue scale), peri-operative bleeding, and post-operative episodes of blood-stained saliva, consultation rate, tonsillar bed healing and days before return to regular diet. One hundred and five patients were included.

Results:

Peri-operative bleeding was significantly reduced in the local anaesthesia group compared with the other two groups. Delayed post-operative tonsillar bed healing was noted in the diathermy group. No other significant differences were found between the three haemostasis groups, for any other outcome measures. The presence of blood-stained saliva was associated with higher pain scores.

Conclusion:

Diathermy and compression were associated with similar post-tonsillectomy morbidity.

Keywords

TonsillectomyPost Operative PainHaemostasisCautery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 6 , June 2009 , pp. 648 - 655
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Rungby, JA, Romeling, F, Borum, P. Tonsillectomy: assessment of quality by consultation rate after discharge. J Laryngol Otol 1999;113:135–9CrossRefGoogle ScholarPubMed
2 Lowe, D, van der Meulen, J. Tonsillectomy technique as a risk factor for postoperative haemorrhage. Lancet 2004;364:697–702Google ScholarPubMed
3 Rungby, JA, Romeling, F, Borum, P. Methods of haemostasis in tonsillectomy assessed by pain scores and consultation rates. The Roskilde County Tonsillectomy Study. Acta Otolaryngol Suppl 2000;543:209–14CrossRefGoogle ScholarPubMed
4 Lee, WC, Sharp, JF. Complications of paediatric tonsillectomy post-discharge. J Laryngol Otol 1996;110:136–40CrossRefGoogle ScholarPubMed
5 Rasgon, BM, Cruz, RM, Hilsinger, RL Jr , Korol, HW, Callan, E, Wolgat, RA et al. Infiltration of epinephrine in tonsillectomy: a randomized, prospective, double-blind study. Laryngoscope 1991;101:114–18CrossRefGoogle ScholarPubMed
6 Hollis, LJ, Burton, MJ, Millar, JM. Perioperative local anaesthesia for reducing pain following tonsillectomy. Cochrane Database Syst Rev 2000;(2):CD001874Google ScholarPubMed
7 Orntoft, S, Longreen, A, Moiniche, S, Dhal, JB. A comparison of pre- and postoperative tonsillar infiltration with bupivacaine on pain after tonsillectomy. A pre-emptive effect? Anaesthesia 1994;49:151–4CrossRefGoogle ScholarPubMed
8 Goldsher, M, Podoshin, L, Fradis, M, Malatskey, S, Gerstel, R, Vaida, S et al. Effects of peritonsillar infiltration on post-tonsillectomy pain. A double-blind study. Ann Otol Rhinol Laryngol 1996;105:868–70Google Scholar
9 Jebeles, JA, Reilly, JS, Gutierrez, JF, Bradley, EL Jr, Kissin, I. The effect of pre-incisional infiltration of tonsils with bupivacaine on the pain following tonsillectomy under general anesthesia. Pain 1991;47:305–8CrossRefGoogle ScholarPubMed
10 Jebeles, JA, Reilly, JS, Gutierrez, JF, Bradley, EL Jr, Kissin, I. Tonsillectomy and adenoidectomy pain reduction by local bupivacaine infiltration in children. Int J Pediatr Otorhinolaryngol 1993;25:149–54CrossRefGoogle ScholarPubMed
11 Molliex, S, Haond, P, Baylot, D, Prades, JM, Navez, M, Elkhoury, Z et al. Effect of pre- vs postoperative tonsillar infiltration with local anesthetics on postoperative pain after tonsillectomy. Acta Anaesthesiol Scand 1996;40:1210–15CrossRefGoogle ScholarPubMed