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Post-operative pain following coblation or monopolar electrocautery tonsillectomy in children: a prospective,
1Department of Otolaryngology-Head and Neck Surgery, University of Minnesota Medical Center, Minneapolis, MN, USA.
Insights
Coblation tonsillectomy in children may lead to less severe post-operative pain and quicker return to a regular diet compared to electrocautery. This study compared pain outcomes for coblation versus electrocautery tonsillectomy.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Pain Management
Background:
- Tonsillectomy is a common pediatric surgical procedure.
- Post-operative pain is a significant concern following tonsillectomy.
- Coblation and electrocautery are two common methods for tonsillectomy.
Purpose of the Study:
- To compare post-operative pain in children undergoing tonsillectomy using coblation versus monopolar electrocautery.
- To evaluate the impact of each surgical method on pain severity, pain medication use, and dietary recovery.
Main Methods:
- A prospective, single-blinded, randomized controlled trial involving 80 pediatric patients.
- Patients were divided into two groups: coblation tonsillectomy (n=40) and electrocautery tonsillectomy (n=40).
- Post-operative pain, pain medication requirements, and time to resume a regular diet were assessed daily via a survey.
Main Results:
- Coblation tonsillectomy resulted in fewer days of severe post-operative pain (4.2 days) compared to electrocautery (5.9 days) (P=0.006).
- Patients undergoing coblation also had fewer days with pain rated ≥ 5 (3.6 days vs. 4.8 days) (P=0.037).
- No significant differences were observed in codeine use or time to resume a regular diet between the two groups.
Conclusions:
- Coblation tonsillectomy appears to be associated with reduced post-operative pain in children compared to electrocautery.
- Coblation may offer a potential advantage in managing post-tonsillectomy pain and facilitating faster dietary recovery.
Objective:
To compare post-operative pain following tonsillectomy by either coblation or monopolar electrocautery in children.
Design:
A parallel-designed, prospective, single-blinded, randomised trial.
Setting:
Ambulatory surgical facility.
Study Participants:
Eighty otherwise healthy paediatric patients undergoing coblation or electrocautery tonsillectomy by a fellowship-trained paediatric otolaryngologist.
Main Outcome Measures:
(i) The number of post-operative days with severe pain based on subjective qualification by the caretaker, (ii) post-operative days with pain rated ≥ 5 on a scale of 1-10, (iii) post-operative days requiring oral paracetamol/acetaminophen with codeine solution and (iv) post-operative days until resumption of a regular diet were assessed and recorded daily using a post-operative pain survey as a form of daily diary that was returned at the 2-week follow-up visit.
Results:
Patients were consecutively enrolled into two groups of 40 patients. Average ages were 5.2 years for coblation tonsillectomy and 6.0 years for electrocautery tonsillectomy. The average number of post-operative days with severe pain was 4.2 for coblation and 5.9 for electrocautery (P = 0.006), days rating pain ≥ 5 were 3.6 for coblation and 4.8 for electrocautery (P = 0.037), days of codeine use were 2.5 for coblation and 2.9 for electrocautery (P = 0.324), and days until resumption of a regular diet were 5.2 for coblation and 6.2 for electrocautery (0.329).
Conclusions:
Coblation tonsillectomy may reduce post-operative pain and the time until resumption of a regular diet compared to electrocautery tonsillectomy.
