Related Experiment Video
Updated: May 31, 2026
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Is the systemic inflammatory reaction to surgery responsible for post-operative pain after tonsillectomy, and is it
Zeljka Roje1, Goran Racic, Goran Kardum
1Department of ENT, Head and Neck Surgery, Split University Hospital, Split, Croatia. zroje@kbsplit.hr
Insights
Choosing a less aggressive tonsillectomy technique, such as radiofrequency tonsillectomy, can reduce post-operative pain and inflammation. This leads to quicker recovery and less overall morbidity in children undergoing tonsillectomy.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Oncology
Background:
- Tonsillectomy is a common surgical procedure in children.
- Postoperative morbidity and systemic inflammatory response are significant concerns following tonsillectomy.
- The choice of surgical technique may influence these outcomes.
Purpose of the Study:
- To investigate the impact of operative technique on post-tonsillectomy morbidity and systemic inflammation.
- To compare pain, recovery time, and inflammatory response between conventional and radiofrequency tonsillectomy in children.
- To correlate inflammatory markers with postoperative outcomes.
Main Methods:
- A prospective, randomized, single-blind study of 100 children (3-16 years) undergoing tonsillectomy.
- Patients were randomized to conventional tonsillectomy (bipolar diathermy) or radiofrequency tonsillectomy.
- Postoperative pain, analgesic use, recovery time, hemorrhage, and serum C-reactive protein (CRP) levels were assessed over 14 days.
Main Results:
- Conventional tonsillectomy led to a statistically significant increase in postoperative CRP levels.
- Elevated CRP levels correlated with increased analgesic consumption and longer recovery times.
- Higher CRP levels were associated with a delayed resumption of normal physical activities.
Conclusions:
- Postoperative morbidity after tonsillectomy is linked to the systemic inflammatory response.
- The surgical technique significantly influences the inflammatory response.
- Less aggressive techniques, like radiofrequency tonsillectomy, result in weaker inflammatory responses and reduced morbidity.
Aims:
Investigate the influence of operative technique on post-operative morbidity and the systemic inflammatory response after tonsillectomy. In addition, our aim was to compare the systemic inflammatory reaction, post-operative pain severity, and required time before the resumption of normal physical activity between two groups of tonsillectomized children and to correlate characteristics of the systemic inflammatory reaction to post-operative morbidity.
Participants And Methods:
This prospective, randomized, and single-blind study included 100 children between the ages of 3-16 years and who were scheduled for a tonsillectomy at our department for chronic tonsillitis and/or respiratory obstruction. The children were randomly assigned into one of two groups: either a conventional tonsillectomy with bipolar diathermy coagulation or a radiofrequency tonsillectomy procedure; both groups had a 14-day follow-up. We investigated the severity and duration of postoperative pain (based on the use of analgesics during the postoperative period), the postoperative day that they resumed normal physical activity, and the rate of postoperative hemorrhage. In order to assess the systemic inflammatory response, serum C-reactive protein (CRP) levels were measured before the surgery and seven days after the procedure.
Results:
After the surgery CRP levels increased to a statistically significant level (t = -4.7; p < 0.001) in conventional tonsillectomy group. There was a statistically significant correlation between increased blood CRP levels after the surgery and the level of post-operative analgesic consumption, which was based on an increased number of analgesic applications (r = 0.28; p < 0.01) and a greater number of days in which analgesics were consumed (r = 0.26; p < 0.01). There was also a correlation between increased blood CRP levels and a longer required time to resume normal physical activities (r = 0.30; p < 0.01).
Conclusion:
Post-operative morbidity after tonsillectomy appears to depend on the systemic inflammatory response to surgery. This response is "technique-related," wherein a less-aggressive surgical technique produces a weaker post-operative inflammatory response and less post-operative morbidity.
Related Concept Videos
01:26Tonsillitis II: Management
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:25Acute Inflammation III: Local and Systemic Effects
01:24General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...