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Related Experiment Videos

A prospective randomised single blinded study comparing harmonic scalpel tonsillectomy with bipolar tonsillectomy.

Matthew Leaper1, Murali Mahadevan, David Vokes

  • 1Department of Paediatric Otolaryngology, Auckland Children's Hospital, Park Road, Auckland, New Zealand. mattkyla@xtra.co.nz

International Journal of Pediatric Otorhinolaryngology
|March 23, 2006
PubMed
Summary

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Pediatric tonsillectomy using a harmonic scalpel resulted in slightly higher pain scores compared to bipolar diathermy in the first six days post-surgery. Both surgical techniques demonstrated similar safety profiles regarding bleeding and analgesic use.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery

Background:

  • Tonsillectomy is a common pediatric surgical procedure.
  • Post-tonsillectomy pain management and surgical technique efficacy are critical concerns.

Purpose of the Study:

  • To compare post-tonsillectomy pain, analgesic consumption, and bleeding rates between harmonic scalpel and bipolar diathermy techniques in children.
  • To evaluate the safety and effectiveness of two distinct surgical methods for pediatric tonsillectomy.

Main Methods:

  • A randomized controlled trial involving 204 children aged 6-15 years undergoing tonsillectomy.
  • Patients were allocated to either harmonic scalpel or bipolar diathermy groups.
  • Post-operative pain (VAS 0-10), analgesic use, and bleeding were monitored via in-person assessments and daily telephone follow-ups for 13 days.

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Main Results:

  • Children reported moderate post-operative pain for the first 6 days, gradually decreasing by day 11.
  • The harmonic scalpel group (n=103) experienced significantly higher mean pain scores for current pain, worst pain, and pain on swallowing compared to the bipolar diathermy group (n=101).
  • Analgesic use was comparable between groups, and rates of hospital readmission for bleeding (9% vs. 11%) and surgical re-exploration (4% vs. 2%) were similar for both techniques.

Conclusions:

  • Tonsillectomy is associated with significant post-operative pain, particularly in the first week.
  • While harmonic scalpel tonsillectomy showed a slight increase in pain compared to bipolar diathermy, both methods are deemed effective and safe.
  • The findings suggest careful pain management is crucial for pediatric tonsillectomy regardless of the surgical modality used.