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Fibrin sealant reduces pain after tonsillectomy: prospective randomized study
Michael Vaiman1, Daniel Krakovski, Haim Gavriel
1Department of Otolaryngology, Assaf Harofe Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
The Annals of Otology, Rhinology, and Laryngology
|August 12, 2006
Summary
Tonsillectomy using fibrin sealant results in less postsurgical pain than electrocoagulation. Surface electromyography (sEMG) effectively assesses swallowing pain after tonsillectomy.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Pain Management
Background:
- Tonsillectomy is a common procedure often associated with significant postsurgical pain.
- Hemostasis techniques, such as fibrin sealant and electrocoagulation, may influence patient outcomes and pain levels.
- Objective assessment of postsurgical pain and swallowing function remains a challenge.
Purpose of the Study:
- To compare postsurgical pain and swallowing function following tonsillectomy using fibrin sealant versus electrocoagulation.
- To evaluate the utility of surface electromyography (sEMG), dysphagia severity rating scale (DSRS), and visual analog scale (VAS) for pain assessment.
Main Methods:
- A comparative study involving 80 adult patients undergoing tonsillectomy.
- Hemostasis achieved via fibrin sealant spray (Group 1) or electrocoagulation (Group 2).
- Assessment using sEMG of swallowing muscles, DSRS, and VAS pain scores over 30 days.
Main Results:
- Both techniques showed increased muscle electrical activity compared to norms; swallowing timing was less affected.
- Fibrin sealant technique resulted in significantly less pain than electrocoagulation.
- DSRS correlated strongly with sEMG; VAS pain scores were less informative.
Conclusions:
- Fibrin sealant is a less painful and traumatic hemostasis method post-tonsillectomy compared to electrocoagulation.
- Surface electromyography (sEMG) offers a reliable, objective method for evaluating post-tonsillectomy swallowing pain.
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